The guidelines for the diagnosis and treatment of spasticity

I. Dones, V. Nazzi, G. Broggi

Research output: Contribution to journalArticlepeer-review


Spasticity is a predominant clinical sign appearing in different neurological diseases. It is always flanked by various degrees of muscle weakness. The clinical evaluation of a spastic patient is score according to varius internationally approved evaluation scales (Ashworth scale, muscle spasms scale, and FIM disability scale). The treatment of spasticity is mostly a symptomatic treatment aimed to relief muscle hypertonus thus increasing both motor performance and improving nursing. Many molecules are frequently being used orally with poor results or with the onset of undesired side effects. In fact oral baclofen, diazepam and tizanidine often have poor effect on spasticity and bring frequently to the appearance of undesired side effects caused by the concentration of these molecule at the brain level. Intrathecal baclofen is a good option to treat diffuse spasticity through the infusion of baclofen into the spinal CSF space. When baclofen is administered intrathecally at the spinal level it distributes with a concentration-gradient between caudal and rostral level of the spine that was calculated as 4:1 thus avoiding its concentration at the brain level when given at a therapeutical dosage. This fact avoids any undesired side effect due to the action of baclofen at the brain level. Botulinum toxin as well as peripheral neurotomies are very helpful in those cases in whom spasticity is mainly restricted to few muscular groups. A correct flowchart to diagnose and treat the patient is mandatory to achieve the best results for each patient according to his spasticity and residual motor ability.

Original languageEnglish
Pages (from-to)101-105
Number of pages5
JournalJournal of Neurosurgical Sciences
Issue number4
Publication statusPublished - Dec 2006


  • Guidelines
  • Spasticity, diagnosis
  • Spasticity, therapy

ASJC Scopus subject areas

  • Clinical Neurology


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