How is spasticity treated in traumatic brain injury (TBI)?

Updated: Feb 01, 2018
  • Author: Percival H Pangilinan, Jr, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Guidelines for the treatment of spasticity are generally based on (1) any resulting limitation in function, (2) pain, (3) prevention of contracture, and (4) assistance with positioning. [36] First-line treatments for spasticity are correct positioning of the involved body segment and ROM exercises. Second-line treatments include splinting, casting, and other modalities.

Treatment varies according to whether the spasticity is generalized or local. Generalized spasticity is usually treated systemically. Dantrolene sodium is preferred in patients with TBI because of its lack of cognitive and sedative adverse effects.

Other drugs used to manage spasticity include baclofen, tizanidine, clonidine, and benzodiazepines. Their use may be limited because of their sedative and cognitive adverse effects. Local treatments for spasticity include chemical neurolysis with phenol or alcohol injections and with botulinum toxin type A and type B injections.


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