Spasticity management & treatment

---

Spasticity is referred to as tightness or stiffness in a muscle after Stroke, Cerebral palsy, Traumatic brain injury, Spinal cord injury, Multiple sclerosis, Hypoxic brain injury and other neurodegenerative diseases. The presentation of spasticity in muscle can be mild, moderate or severe. Early identification of spasticity, before the joint reaches a stage of immobilised fixed position could prevent complications like pain, interference with daily function, hygiene, comfort, and nursing care as this can increase the risk of pressure ulcers and subsequent infections or dislocations.

Initial consultation is to review history, medications, examination to assess the muscle tone and to check the muscle morphology with ultrasound. Formulate recommendations about appropriate treatment options. If patient is eligible for Botulinum toxin A injection, this can be organised and arranged for the next visit.

Patients could be eligible for oral Medications or Botulinum toxin injection or both. This will be decided from the initial assessment

Botulinum toxin injection is done under ultrasound guidance to improve patient experience compared to muscle stimulation technique through e-Stim.

Paediatric needle is used for the procedure hence topical numbing cream is usually not required. Skin is prepared and cleaned with Alcohol wipe before the procedure.