STEP 2: Spasticity Live Course - April 25-26, 2025, in Rosemont, IL-Focal Interventional Treatment Considerations

Pdf Summary

The presentation on "Interventional Spasticity Management Applications" by Kristin Caldera, DO, focuses on various focal treatment methods for managing spasticity. The discussion covers both pharmacologic and non-pharmacologic interventions, emphasizing personalized and precise treatment strategies.

<strong>Pharmacologic Treatments:</strong>
- <strong>Nerve Blocks:</strong> Utilize local anesthetics like Bupivacaine and Lidocaine for temporary relief by inactivating sodium channels. They help distinguish spasticity from contractures.
- <strong>Chemoneurolysis:</strong> Involves agents such as phenol or ethyl alcohol to disrupt nerve functions effectively but can lead to dysesthesias and requires careful dose management.
- <strong>Botulinum Toxin Injections:</strong> Derived from Clostridium botulinum, these injections block acetylcholine release at the neuromuscular junction, offering focal relief without impacting the CNS. However, they require repetition and pose risks like procedural pain and potential systemic spread.

<strong>Non-Pharmacologic Treatments:</strong>
- <strong>Cryoneurolysis:</strong> A peripheral nerve-targeted procedure using nitrous oxide to induce nerve degeneration without damaging connective tissues.
- <strong>Hyaluronidase Injections:</strong> An off-label option targeting muscle stiffness by addressing excess hyaluronan in the extracellular matrix.
- <strong>Surgical Interventions:</strong> Include tendon transfers, dorsal rhizotomy, and neurotomies, aimed at decreasing muscle overactivity through structural alterations.

The presentation highlights that there is no one-size-fits-all approach to treating spasticity. Instead, individualized combinations of therapies are often necessary to achieve the best outcomes. The discussion includes potential advantages and disadvantages of each treatment option, emphasizing the importance of a multifaceted strategy in spasticity management.

Asset Subtitle

Kristin E. Caldera, DO

Keywords

Interventional Spasticity Management

Kristin Caldera

focal treatment

pharmacologic interventions

non-pharmacologic interventions

nerve blocks

chemoneurolysis

Botulinum Toxin Injections

cryoneurolysis

surgical interventions