The Management of Spasticity in Multiple Sclerosis

Abstract

Spasticity, defined as a velocity-dependent increase in tonic stretch reflexes, is common in patients with multiple sclerosis due to plaque formation in the brain and spinal cord. Treatment of spasticity is generally considered when the increase in tone interferes with functional activities, such as bed or wheelchair positioning, transfers, ambulation, or daily care; when it is painful; or when it leads to complications such as contractures or skin breakdown. This paper reviews the pathophysiology of spasticity and discusses treatment options, including general medical and nursing cares, physical and occupational therapy approaches, use of splints and orthoses, oral and intrathecal medications, nerve blocks, botulinum toxin injections, and orthopedic and neurosurgical procedures.