Spasticity Clinic of Metropolitan General is one of the few, organized centers in the country. It uses the most developed therapeutical approach for the effective treatment of focal spasticity.
Ιt cooperates closely with Physical Therapy Unit of the Clinic to program and to perform the suitable accompanying rehabilitation programs of the patients.
What is Spasticity?
Spasticity is a movement disorder, resulting from a damage of the Central Nerve System (brain and/or spinal cord), where the tendon reflexes increase and there is a continuous involuntary increase of the muscle tone of specific muscle groups.
The duration of the normal movement is disturbed and gradually hypertonia, painful contraction of antagonist muscle groups and clone appear, and gradually the width of the movement of the affected joints is reduced. As a consequence, performing daily needs, such as getting dressed, eating and physical hygiene becomes difficult and the patient feels limited concerning his daily activities. For example, spasticity of the lower limb causes the so called “sickle” walking.
When spasticity affects specific muscle groups of the upper or lower limb, is called focal.
Which diseases show spasticity?
The most important are the following:
- Vascular Stroke
- Skull-brain injury
- Spinal cord injury
- Multiple sclerosis
- Cerebral palsy
Modern treatment of spasticity
The treatment of focal spasticity is done with the help of botulinum toxin (known as BOTOX), a protein that is produced by the bacterium Clostridium botulinum. It is commercialized in two (2) packages: as Botox (Allergan) and as Dysport (Ipsen). Its actions prevent the transmissions of stimuli from the nerve to the muscle, causing a local and temporary muscle relaxation. Although most of the people know the toxin from the use for the elimination of wrinkles, it is a valuable drug for the treatment of spasticity.
How is performed the assessment for the administration of botulinum toxin?
After a detailed clinical examination of the patient, which includes the assessment of the functionality, equilibrium, walking, muscle strength, the movement range of the joint and of the grade of spasticity, it is decided which muscles need injection and how many units of the drug are necessary.
It should be noted that the National Organization for Health Care Services Provision, compensates the neurological drugs of high-cost (Botox, Dysport) after an informed electronic report of the attending physician.
The injection of botulinum toxin is performed locally and inside the mass of the spastic muscle, almost painlessly using a fine needle, assisted by electromyography (when it is considered necessary). The procedure lasts 15 to 30 minutes, depending to the disease.
Which are the results of botulinum toxin in spasticity?
The results appear after a few days and they top in two (2) to four (4) weeks:
- the muscle hyperactivity ceases
- pain is reduced
- movements are performed more comfortably
- the functionality of the affected limbs is improved
The action lasts three (3) to four (4) months, however in regular periods of time, the injection should be repeated.
Even in patients which show chronic established hemiplegia, where the result of the drug in the movement is not the same, the decrease of the pain which spasticity causes is important.
The advantage of botulinum toxin versus per os treatments is that it actions locally. The patients with neurological diseases should be as much as possible active in the rehabilitation and as a result the administration of drugs that enter blood circulation and cause somnolence and generalized relaxation should be avoided.
We should stress that the treatment of spasticity with botulinum toxin should begin οn time, in order to avoid the disfigurement of the limbs caused by immobility. To be able the patient to profit the best results, an intense rehabilitation program should be applied after the injection of the drug, including kinesiotherapy, working therapy and re-education of movement.
The Spasticity Clinic cooperates closely with the Physical Therapy Unit of Metropolitan General, which could treat in multiple levels and individually such cases.
Staff
Dogka Anastasia, Physiatrist
specialized in neurological disease rehabilitation
Contact tel: +30 210 650 2903 - 4
