J Korean Med Assoc.  2022 Feb;65(2):117-122. 10.5124/jkma.2022.65.2.117.

Pharmacological management of muscle spasticity

• Ko EJ
• Kim DY

• KMID: 2526619
• DOI: http://doi.org/10.5124/jkma.2022.65.2.117

Abstract

Background
Muscle spasticity is a neurologic disorder, which is considered one of the positive signs of upper motor neuron diseases. Spasticity is common after brain or spinal cord injury. Since spasticity results in tendon retraction, muscle weakness, pain, ankylosis, and disability in activities of daily living, treatment is warranted.
Current Concepts
Spasticity is usually assessed using the Modified Ashworth Scale or Modified Tardieu Scale. It is treated with various methods, including physical therapy, occupational therapy, orthosis, medication, and surgery. Pharmacological management should be selected according to the location and severity of the symptom and includes oral medications, chemical nerve block, and intrathecal baclofen pump insertion. Oral medications include baclofen, benzodiazepine, dantrolene, and tizanidine. Chemoneurolysis of spasticity is done with botulinum toxin or a mixture of phenol and alcohol.
Discussion and Conclusion
Since muscle spasticity affects motor function and activities of daily living, understanding of this symptom and choosing an optimal treatment are necessary. Pharmacologic treatments should be administered with caution especially with the side effects. Optimal treatment of spasticity will bring the best neurological outcome for the patients.

Keyword

Muscle spasticity; Drug therapy; Motor activity; Activities of daily living; 근육경직; 약물요법; 운동능력; 일상활동