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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)
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REVIEWS  UPPER MOTOR NEURON SYNDROME: EVALUATION AND TREATMENT OF SPASTICITY
Guest Editor: FRANCO MOLTENI
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Europa Medicophysica 2004 June;40(2):131-43

Copyright © 2004 EDIZIONI MINERVA MEDICA

lingua: Inglese

The role of intrathecal baclofen therapy in the upper motor neuron syndrome

Francisco G. E.

1 Physical Medicine and Rehabilitation University of Texas Health Sciences Center Houston, TX, USA 2 Physical Medicine and Rehabilitation Baylor College of Medicine, Houston, TX, USA 3 Research Services, Brain Injury and Stroke Program Institute for Rehabilitation and Research, Houston, TX, USA


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This ­review arti­cle ­will dis­cuss the appli­ca­tion of intra­the­cal baclof­en (ITB) ther­a­py in the ­upper ­motor neu­ron syn­drome (­UMNS). While the ­UMNS con­sists of a varie­ty of ­signs and symp­toms, spas­tic­ity ­appears to be the ­most wide­ly dis­cussed in ­research and clin­i­cal prac­tice. Thus, ­while a varie­ty of ­motor dis­or­ders ­result ­from spas­tic­ity and the oth­er com­po­nents of the ­UMNS, ­such as dys­to­nia, rigid­ity, and co-con­trac­tion of ago­nists and antag­o­nists, we ­will ­refer to spas­tic­ity as the rep­re­sen­ta­tive pathol­o­gy of the ­UMNS. The ­term spas­tic­ity ­will be ­used in ­this dis­cus­sion as if it ­were syn­on­y­mous to the ­UMNS, ­because it is the ­term ­used in ­most pub­lished ­research and ­papers. This ­does not nec­es­sar­i­ly ­mean ­that the oth­er fea­tures of the ­UMNS are ­less impor­tant. Publications in the use of ITB in the pedi­at­ric pop­u­la­tion, espe­cial­ly cere­bral pal­sy, ­abound, but ­this ­paper ­will ­focus on ­UMNS in ­adults. In addi­tion to review­ing the pro­cess of ITB man­age­ment, ­from ­patient selec­tion to reha­bil­i­ta­tion, top­ics of prac­ti­cal inter­est to cli­ni­cians ­will be dis­cussed.

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