Join Now | Sign in

State-of-the-Art Treatments f... Video Transcript

Videos (10)

	When Muscles Won't Relax: Understanding Post-Stroke Spasticity play video read transcript
	Treating Post-Stroke Spasticity: What Your Doctor Needs to Know play video read transcript
	Rehabilitation After Stroke: What Can Be Done? play video read transcript
	Stroke Recovery: The Basics of Physical Rehabilitation play video read transcript
	Life After Stroke: Personal Perspectives play video read transcript
	TIA: A Warning Not to be Ignored play video read transcript
	Are You at Risk for a Stroke? play video read transcript
	What are the Warning Signs of a Stroke? play video read transcript
	Helping a Loved One Recover From a Stroke play video read transcript
	Caregiver Involvement in Post-Stroke Care play video read transcript

Marketplace

State-of-the-Art Treatments for Post-Stroke Spasticity

play videoTime: 07:22 minutes

Licensed from

Page: 1 2 Next >

Participants

Alberto Esquenazi MD, Cindy Ivanhoe MD, Nathaniel H. Mayer MD

Summary

Among the many serious consequences of a stroke, one of the most physically debilitating is "spasticity," or uncontrolled muscle tightness. Pain and restricted movement can make day-to-day life a struggle, but cutting-edge treatments like Botox and intrathecal baclofen (ITB) are helping patients ease the tension.

Webcast Transcript

ANNOUNCER: The treatment of stroke patients has seen several advances in recent years, and among the most significant are two new therapies for a post-stroke condition called spasticity.

CINDY IVANHOE, MD: Spasticity is the increased resistance to stretch or movement that you can feel across joints. And it happens when there's been an injury to the central nervous system, whether it's a stroke or spinal cord injury or whatever. It can interfere with function by causing deformity, interfering with movement, causing pain, and all those things will translate into decreased function.

ANNOUNCER: Left untreated, spasticity can have a profound impact on an individual's quality of life.

CINDY IVANHOE, MD: Physically, it limits their ability to move. It affects the quality of their gait, or the way they walk. It affects the quality of their transfers, or how they move from a wheelchair to a bed to standing to going to the bathroom. All those things will have an effect, as well, on their quality of life.

ANNOUNCER: But although spasticity is a major consequence of stroke and other conditions, for decades the treatment options were limited and less than ideal. These included oral agents like Valium, Dantrium and Lioresal.

ALBERTO ESQUENAZI, MD: One of the major issues with those treatments is that they have a series of side effects, most commonly sedation or sleepiness and weakness. There are other, more severe side effects, such as hallucinations or even having difficulty with sleep. But they all produce some type of unpleasant side effect. And oral agents are delivered through the whole body where your spasticity may be only in an arm or a leg, so it doesn't make sense to give you a pill that goes everywhere when all you need is a medication that will deal with the problem where it is.

ANNOUNCER: Today the older drugs are being put aside in favor of two treatments that have brought new hope to patients with spasticity.

CINDY IVANHOE, MD: Botulinum toxin and intrathecal baclofen are cutting-edge treatments for spasticity because they're the first really effective, new treatments that we've had for spasticity in decades. The intrathecal baclofen has a huge, dramatic effect on my patients' lives. The Botox injections, as well, have a huge effect on specific patients.

ANNOUNCER: Botox works by entering nerve endings around the muscle where it is injected and blocking the release of chemical messages that causes the muscle to contract.

NATHANIEL H. MAYER, MD: Now, if the message from the brain to the muscle were a good message, than it would not be a good thing to block it. But in the case of spasticity, there are excessive messages-- too many messages that are not a good thing because they make the muscle overactive.

ANNOUNCER: And since Botox is effective for about three months per injection, patients can enjoy its benefits without great inconvenience. Because Botox affects only the area where it's injected and blocks nerve messages rather than harming the nerves, it's less likely to produce negative side effects.

CINDY IVANHOE, MD: Patients may have a little bit of bleeding at the site of an injection. They may have a little bit of tenderness during the injection. Some patients have had some flu-like symptoms for a while following an injection, but overall, the side effect profile is quite limited.

ANNOUNCER: By blocking muscle activity, Botox can treat a number of problems, and the FDA has approved Botox for conditions like crossed eyes, neck and shoulder spasms, and facial wrinkles, but not spasticity. Doctors who treat spasticity, however, have taken advantage of the drug's muscle calming effects.

NATHANIEL H.

Page: 1 2 Next >