Published in: Today Digital
Author: Dr. Francisco De la Rosa, Specialist in Rehabilitation Medicine, Management of Physical Medicine and Rehabilitation, Spasticity and its Treatment.
Patients with global or generalized spasticity who will benefit from oral medications, physical and occupational therapy, and in most cases specialized orthoses should be separated from those who suffer focal spasticity after the first evaluation, or follow-up consultations.
Then we must ask ourselves: Are we fulfilling the proposed goals for treatment or are we only replenishing the use of oral medication and are we static in the progression? After the rehabilitation program (TF / TO), have the objectives been met or the doctor and / or patient want to continue working on the symptoms?
Does it have a contraindication for the other treatments? These questions will give us an idea of what is happening with our patient, and if it is necessary to climb a step in the complexity of management.
Botulinum toxin is derived from the bacterium that causes botulism (Clostridium Botulinum), a disease that produces flaccid muscle paralysis (the opposite of spasticity). It was identified more than 30 years ago for the treatment of it and has become the first line of treatment for focal spasticity.
Being this an extremely powerful toxin, it has risks that are handled with training and with an application that respects the therapeutic margins for each age and weight.
You have to plan clear goals, with understanding by the patient of what is being pursued, and accompany this with coadjuvant treatments such as physical and occupational therapy, and serial splinting when required.