Spasticity may be one of the symptoms of MS and should definitely be treated. Both pharmacotherapy and specific rehabilitation are used to treat spasticity in MS. Sometimes patients are also used other methods of treating spasticity, such as intramuscular injection of botulinum toxin or intrathecal administration of drugs using pumps.

Multiple sclerosis spasticity( SM ,sclerosis multiplex ) means stiffness and excessive , extremely increased muscle tension, which occurs as a result of disturbances in the transmission of nerve impulses to the muscles. In multiple sclerosis, the structures of nerve fibers are demyelinated, which means that the muscles do not receive nerve signals properly and their activity occurs in a chaotic, spontaneous manner. multiple sclerosis most often affects the lower limbs. The pathology may affect various muscle groups. If the spasticity affects the muscles of the lower limbs flexors, patients may have permanent contracture in the hip and knee joints, and there may be difficulties in straightening these joints. The opposite is true in the case of spasticity of the extensor muscles of the lower extremities - in its course, patients 'legs are straightened, it is also characteristic that patients' legs are placed very close to each other. in the end, a steady state. There are also patients whose spasticity is exacerbated by certain phenomena. Factors that can exacerbate these types of muscle problems include exposure to cold or the development of an infection.

Spasticity in MS: what can it lead to?

Spasticity can lead to movement disorders in the first place. There are also other risks associated with it, including (especially in the absence of treatment) the risk of permanent joint contractures. Patients experiencing spasticity may also complain of pain, often of a high degree. Another problem that has been associated with spasticity in multiple sclerosis is formation in patientsbedsores.

Spasticity in MS: drug treatment

The goals of treating spasticity in MS are to increase the mobility of patients, reduce the risk of the above-mentioned complications of this condition, and alleviate the pain symptoms experienced in patients. Spasticity leads not only to problems for the experiencing patient, but also for those around him. In a situation where the patient requires care from his relatives, excessively stiff muscles may, for example, make it difficult to perform basic hygienic activities. Pharmacological treatment of spasticity in MS uses preparations from various drug groups. Currently, the most commonly used measures are:

  • baclofen
  • tizanidine
  • benzodiazepines (e.g. diazepam or clonazepam)

Thanks to the use of the above-mentioned preparations, it is actually possible to improve the muscle function in MS patients, but this type of treatment is not without its drawbacks. For example, patients may experience excessive sleepiness and fatigue while taking baclofen or benzodiazepines. In turn, people taking tizanidine may develop liver dysfunction or excessive dry mouth. Individual preparations can be used as monotherapy, but sometimes - in order to reduce the side effects of drugs - patients are treated with, for example, two preparations at the same time (in such a situation lower doses of drugs are used than in monotherapy, thanks to which the risk of various side effects is reduced) .

Spasticity in MS: other treatments

In addition to pharmacotherapy, rehabilitation effects play a significant role in managing spasticity in MS. Regular exercise under the supervision of a physiotherapist can bring invaluable benefits in alleviating spasticity symptoms. Drug treatment and rehabilitation are essential methods of helping MS patients experiencing spasticity. Some people are also used for other effects, such as botulinum toxin injections. Administration of this preparation to the area of ​​the affected muscles abolishes the increased muscle tension, but it should be clearly noted that such a result is, unfortunately, transient - the effects of botulinum toxin injection last for about 3 months. . In this way, phenol can be administered, which causes blockage of the anterior roots of the spinal cord, and thereby the drug suppresses spasticity for about three to twelve months. Anotheran example of intrathecal use of drugs in MS is the 24-hour administration of baclofen using special pumps. Other alternative treatments for MS spasticity are transient or permanent nerve blocks. In the first case, phenol or alcohols can be used to block the function of peripheral nerves, while permanent nerve blocks are obtained by trimming the anterior roots of the spinal cord (this procedure is used in patients who are not expected to improve in spasticity).

Early rehabilitation in MS - a role in MS treatment

Why should rehabilitation in multiple sclerosis be as early as possible and on what levels? What is the role of early rehabilitation in the treatment of MS? These questions are answered by Magdalena Fac-Skhirtladze, secretary general of the Polish Multiple Sclerosis Society.

Category:

Neurology