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ULTIMO FASCICOLOEUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063

Periodicità: Bimestrale

ISSN 1973-9087

Online ISSN 1973-9095

 

Europa Medicophysica 2004 Giugno;40(2):123-30

UPPER MOTOR NEURON SYNDROME: EVALUATION AND TREATMENT OF SPASTICITY
Guest Editor: FRANCO MOLTENI 

 REVIEWS

Selective neuromuscular blocks and chemoneurolysis in the localized treatment of spasticity

Carda S., Molteni F.

Ospedale Valduce, Villa Beretta Costamasnaga, Lecco

Selective neu­ro­mus­cu­lar ­blocks and chem­o­neu­rol­y­sis are cur­rent­ly the ­most wide­spread ther­a­pies for treat­ing local­ized or loco­re­gion­al spas­tic­ity. Both pro­ce­dures ­present advan­tag­es and dis­ad­van­tag­es. The ­main advan­tag­es of BTX-A are its rel­a­tive ­ease of use, low inci­dence of ­side ­effects, rever­sibil­ity and ele­vat­ed effi­ca­cy. Its dis­ad­van­tag­es are the lim­it­ed max­i­mum ­dose, ­which ­does not per­mit the treat­ment of ­many mus­cles simul­ta­ne­ous­ly, espe­cial­ly if ­they are ­large, and its rel­a­tive­ly ­high ­cost. Phenol neu­rol­y­sis has a low ­cost, ele­vat­ed effi­ca­cy in the con­trol of path­o­log­ic mus­cle over­ac­tiv­ity, and ­long dura­tion of ­effect. Its dis­ad­van­tag­es are the ­risk of inju­ry to the vas­cu­lar and sen­so­ry struc­tures and the dif­fi­cul­ty in per­form­ing the pro­ce­dure. The ­risks asso­ciat­ed ­with neu­rol­y­sis ­have led to an increas­ing inter­est in and use of BTX-A, mak­ing it one of the ­most wide­ly ­used ther­a­pies in treat­ing local­ized spas­tic­ity. From the per­spec­tive of a bal­anced ben­e­fit-­risk anal­y­sis, a ­viable ­option for ­some cas­es may be to com­bine phe­nol neu­rol­y­sis for treat­ing spas­tic­ity in ­large prox­i­mal mus­cles and BTX-A for treat­ing hyper­to­nia in ­small dis­tal mus­cles.

lingua: Inglese


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