Spastyczność w chorobach neurologicznych – zasady postępowania Artykuł przeglądowy
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Opublikowane:
cze 30, 2013
Słowa kluczowe:
spastyczność, baklofen, tolperyzon, toksyna botulinowa, neuroliza, fizjoterapia
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Abstrakt
W pracy szeroko omówiono współczesne zasady postępowania z chorymi ze spastycznością, w oparciu o podstawy patofizjologiczne. Spastyczność jest objawem klinicznym towarzyszącym wielu schorzeniom neurologicznym: udarowi mózgu, stwardnieniu rozsianemu, urazom mózgu i rdzenia oraz mózgowemu porażeniu dziecięcemu. Prawidłowe postępowanie w przypadku spastyczności jest możliwe po dokładnej ocenie klinicznej. Współcześnie stosuje się postępowanie niefarmakologiczne: fizjoterapię, a w wybranych przypadkach leczenie chirurgiczne, oraz leczenie farmakologiczne: ogólne (tyzanidyna, baklofen, diazepam, tolperyzon, dantrolen) i miejscowe (etanol, fenol, toksyna botulinowa typu A). Dobór stosowanej terapii wynika ze stopnia zaawansowania spastyczności, choroby podstawowej i możliwości terapeutycznych. Leczenie powinno być w maksymalnym stopniu zindywidualizowane i dostosowane do potrzeb i oczekiwań pacjenta. Skuteczne leczenie spastyczności przyczynia się do znacznej poprawy funkcjonowania pacjenta i jakości jego życia.
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Jak cytować
Zaborski, J. (2013). Spastyczność w chorobach neurologicznych – zasady postępowania . Medycyna Faktów , 6(2(19), 57-62. Pobrano z https://journalsmededu.pl/index.php/jebm/article/view/2415
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Bibliografia
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16. Cooper A., Musa I.M., van Deursen R., Wiles C.M.: Electromyography characterization of stretch responses in hemiparetic stroke patients and their relationship with the Modified Ashworth scale. Clin. Rehabil. 2005; 19: 760-6.
17. van der Salm A., Veltink P.H., Hermens H.J., Ijzerman M.J., Nene A.V.: Development of a new method for objective assessment of spasticity using full range passive movements. Arch. Phys. Med. Rehabil. 2005; 86: 1991-7.
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26. Sheean G.: Botulinum toxin treatment of adult spasticity: a benefit-risk assessment. Drug Saf. 2006; 29: 31-48.
27. McGuire J.R.: Effective use of chemodenervation and chemical neurolysis in the management of poststroke spasticity. Top. Stroke Rehabil. 2001; 8: 47.
2. Yeargin-Allsopp M., van Naarden Braun K., Doernberg N.S., Benedict R.E., Kirby R.S., Durkin M.S.: Prevalence of cerebral palsy in 8-year-old children in three areas of the United States in 2002: a multisite collaboration. Pediatrics 2008; 121: 547-54.
3. Barnes M.P., Kent R.M., Semlyen J.K., McMullen K.M.: Spasticity in multiple sclerosis. Neurorehabil. Neural. Repair. 2003; 17: 66-70.
4. Watkins C.L., Leathley M.J., Gregson J.M., Moore A.P., Smith T.L., Sharma A.K.: Prevalence of spasticity post stroke. Clin. Rehabil. 2002; 16: 515-22.
5. Wichers M.J., Odding E., Stam H.J., van Nieuwenhuizen O.: Clinical presentation, associated disorders and aetiological moments in Cerebral Palsy: a Dutch population-based study. Disabil. Rehabil. 2005; 27: 583-9.
6. Lance J.W.: What is spasticity? Lancet 1990; 335: 606.
7. Welmer A.K., von Arbin M., Widen Holmqvist L., Sommerfeld D.K.: Spasticity and its association with functioning and health-related quality of life 18 months after stroke. Cerebrovasc. Dis. 2006; 21: 247-53.
8. Thompson F.J., Parmer R., Reier P.J., Wang D.C., Bose P.: Scientific basis of spasticity: insights from a laboratory model. J. Child. Neurol. 2001; 16: 2-9.
9. Mayer N.H.: Clinicophysiologic concepts of spasticity and motor dysfunction in adults with an upper motoneuron lesion. Muscle Nerve Suppl. 1997; 6: S1-13.
10. Mayer N.H., Esquenazi A., Childers M.K.: Common patterns of clinical motor dysfunction. Muscle Nerve Suppl. 1997; 6: S21-35.
11. Pierson S.H.: Outcome measures in spasticity management. Muscle Nerve Suppl. 1997; 6: S36-60.
12. Haugh A.B., Pandyan A.D., Johnson G.R.: A systematic review of the Tardieu Scale for the measurement of spasticity. Disabil. Rehabil. 2006; 28: 899-907.
13. Hsieh J.T., Wolfe D.L., Miller W.C., Curt A.: Spasticity outcome measures in spinal cord injury: psychometric properties and clinical utility. Spinal Cord 2008; 46: 86-95.
14. Hsieh Y.W., Hsueh I.P., Chou Y.T., Sheu C.F., Hsieh C.L., Kwakkel G.: Development and validation of a short form of the Fugl-Meyer motor scale in patients with stroke. Stroke 2007; 38: 3052-4.
15. Esquenazi A., Mayer N.H.: Instrumented assessment of muscle overactivity and spasticity with dynamic polyelectromyographic and motion analysis for treatment planning. Am. J. Phys. Med. Rehabil. 2004; 83: S19-29.
16. Cooper A., Musa I.M., van Deursen R., Wiles C.M.: Electromyography characterization of stretch responses in hemiparetic stroke patients and their relationship with the Modified Ashworth scale. Clin. Rehabil. 2005; 19: 760-6.
17. van der Salm A., Veltink P.H., Hermens H.J., Ijzerman M.J., Nene A.V.: Development of a new method for objective assessment of spasticity using full range passive movements. Arch. Phys. Med. Rehabil. 2005; 86: 1991-7.
18. Kim D.Y., Park C.I., Chon J.S., Ohn S.H., Park T.H., Bang I.K.: Biomechanical assessment with electromyography of post-stroke ankle plantar flexor spasticity. Yonsei Med. J. 2005; 46: 546-54.
19. Lockley L.: The role of the specialist physiotherapist in the management of spasticity. Way Ahead 2004; 7: 6-7.
20. Goldstein E.M.: Spasticity management: an overview. J. Child. Neurol. 2001; 16: 16-23.
21. Boop F.A., Woo R., Maria B.L.: Consensus statement on the surgical management of spasticity related to cerebral palsy. J. Child. Neurol. 2001; 16: 68-9.
22. Gracies J.M., Nance P., Elovic E. et al.: Traditional pharmacological treatments for spasticity. Part II: General and regional treatments. Muscle Nerve Suppl. 1997; 6: S92-120.
23. Gracies J.M., Elovic E., McGuire J. et al.: Traditional pharmacological treatments for spasticity. Part I: Local treatments. Muscle Nerve Suppl. 1997; 6: S61-91.
24. Tilton A.H.: Injectable neuromuscular blockade in the treatment of spasticity and movement disorders. J. Child. Neurol. 2003; 18(Suppl. 1): S50-66.
25. van Kuijk A.A., Geurts A.C.H., Bevaart B.J.W., van Limbeek J.: Treatment of upper extremity spasticity in stroke patients by focal neuronal or neuromuscular blockade: a systematic review of the literature. J. Rehab. Med. 2002; 34: 51.
26. Sheean G.: Botulinum toxin treatment of adult spasticity: a benefit-risk assessment. Drug Saf. 2006; 29: 31-48.
27. McGuire J.R.: Effective use of chemodenervation and chemical neurolysis in the management of poststroke spasticity. Top. Stroke Rehabil. 2001; 8: 47.