STEP 2: Spasticity Live Course - April 25-26, 2025, in Rosemont, IL-Incidence and Presentation Based on Diagnosis

Pdf Summary

The "Interventional Spasticity Management Applications" document by Dr. Cindy B. Ivanhoe outlines comprehensive approaches for managing spasticity, a symptom often seen in patients with Upper Motor Neuron Syndrome (UMNS). The primary learning objectives include understanding the presentation of UMNS, identifying common diagnoses associated with spasticity such as spinal cord injuries, strokes, multiple sclerosis, traumatic brain injuries, and cerebral palsy, and describing the variability in functional implications of spasticity based on diagnoses. The treatment strategies and importance of considering the natural progression of diseases or injuries in treatment planning are emphasized.<br /><br />Positive signs of UMNS include spasticity, dystonia, and clonus, while negative signs involve weakness and loss of motor control. The document emphasizes a multi-modal approach, suggesting that not all spasticity requires treatment, as it can sometimes be beneficial for functions such as transfers.<br /><br />Common conditions associated with spasticity include spinal cord injury, stroke, multiple sclerosis, traumatic brain injury, and cerebral palsy, with each condition needing tailored interventions. For instance, in post-stroke spasticity, interventions like botulinum toxin and intrathecal baclofen (ITB) are used to reduce muscle stiffness and improve function, whereas in multiple sclerosis, cannabinoids may have supportive roles in managing symptoms.<br /><br />Additional treatment options include non-pharmacologic strategies (e.g., stretching, positioning), medications like Baclofen and Tizanidine, and interventions like botulinum toxin injections and intrathecal delivery systems. Surgical options such as selective dorsal rhizotomy are also discussed. Ultimately, the document advocates for individualized patient management through a systematic approach, considering symptom evolution, response to interventions, and tolerance of side effects.

Asset Subtitle

Cindy B Ivanhoe, MD

Keywords

Interventional Spasticity Management

Upper Motor Neuron Syndrome

spasticity

treatment strategies

spinal cord injury

stroke

multiple sclerosis

cerebral palsy

botulinum toxin

intrathecal baclofen