STEP 2: Spasticity Live Course - April 26-27 in Rosemont, IL-Case-based Discussion: Hemiplegic Stroke Leading to Upper Extremity Chemodenervation

Case-based Discussion: Hemiplegic Stroke Leading to Upper Extremity Chemodenervation

Pdf Summary

Dr. Marilyn Pacheco from Edward Hines VA Jr. Hospital discussed a case study on spastic hemiplegia due to stroke leading to upper extremity chemodenervation in a 56-year-old man named Mr. D. He experienced increased tone in his left arm and leg post-rehabilitation, limiting mobility and causing shoulder pain. Physical exams revealed impairments in the left side's sensation and muscle strength. Treatment plans include discontinuing Flexeril and considering medications like Baclofen, tizanidine, or botulinum toxin injections to targeted muscles such as shoulder abductors, flexors, and pronators. Non-pharmacologic approaches like stretching, heat therapy, and splinting are also recommended. Dosage guidance for various botulinum toxin types and targets for neurolysis were discussed in the management plan. Drawing on references like "Spasticity Diagnosis and Management" by Brashear and Elovic, the discussion emphasized a comprehensive approach combining pharmacologic and non-pharmacologic interventions for effective spasticity management.

Keywords

Dr. Marilyn Pacheco

Edward Hines VA Jr. Hospital

spastic hemiplegia

stroke

upper extremity chemodenervation

Mr. D

Baclofen

tizanidine

botulinum toxin injections

spasticity management