Horses and Zebras in the Spasticity Zoo-Session Presentation

Video Transcription

Video Summary

The session on spasticity management opened with an introduction by Dr. Mike Salino, a physiatrist at Moss Rehab and an associate professor at the Sidney Kimmel College of Medicine. He welcomed the participants to the "Horses and Zebras" session, where experts in spasticity management would present cases to help understand the typical and atypical presentations encountered in a spasticity management clinic. Dr. Dan Moon, a colleague of Dr. Salino at Moss Rehab, shared a case of spasticity in a patient with repetitive biting of the lips. He discussed different orofacial movement disorders such as bruxism, oromandibular dystonia, and orofacial dyskinesias, and possible treatment options for each. Dr. Moon also discussed the use of botulinum toxin injections for the treatment of these conditions. Dr. Resfarid, from the University of Missouri, presented a case of a patient with severe hip flexion and adductor spasticity. He discussed the challenges in finding the right dose of intrathecal baclofen for this patient and the use of titration to achieve optimal control of spasticity. Dr. Kimberly Heckert, a director of spasticity management at Thomas Jefferson University, presented a case of a patient with chronic chest and trunk pain following breast cancer treatment. She discussed the challenges in diagnosing and treating this pain, and ultimately found relief for the patient through the use of botulinum toxin injections. Dr. Nick Ketchum, a physiatrist at the Medical College of Wisconsin, discussed a case of muscular pain and stiffness in a patient with a history of breast cancer. He used ultrasound to help diagnose the condition as a secondary dystonia and found that treatment with botulinum toxin injections provided significant relief. Dr. Salino presented three cases related to intrathecal drug delivery systems, including issues with obtaining telemetry, flipped pumps, and migrated pumps. He discussed the importance of using the correct programmer for the specific system and the use of ultrasound and CT scans to diagnose and manage these issues. Overall, the session provided valuable insights into the diagnosis and management of spasticity and related conditions, highlighting the importance of considering both typical and atypical presentations and using a multidisciplinary approach to care.

Keywords

spasticity management

Horses and Zebras

orofacial movement disorders

botulinum toxin injections

intrathecal baclofen

hip flexion

adductor spasticity

chronic chest and trunk pain

breast cancer treatment

secondary dystonia