Treatments for spasticity and pain in multiple sclerosis: a systematic review

Abstract

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Multipl sklerozda ağrı ve klinik özelliklerle ilişkisi

“…The high EDSS score can suggest that spasticity can produce more pain but also the system contractions causing high EDSS can also affect pain-related pathways. Spasticity and pain co-occurrence was reported as 28-60% (29). Spasticity generally causes non-specific muscle joint pain.…”

Spinal Astrocyte Glutamate Receptor 1 Overexpression after Ischemic Insult Facilitates Behavioral Signs of Spasticity and Rigidity

“…Rigidity is continuous involuntary muscle contraction: the degree of resistance remains constant regardless of the rate at which the muscle is stretched (Maurice et al, 2001). Several pathological conditions can lead to spasticity/rigidity, such as ischemic or traumatic spinal cord injury, brain trauma, multiple sclerosis, cerebral palsy, or Parkinson's disease (Dabney et al, 1997;Dietz, 2001;Beard et al, 2003). Although diverse in etiology, these conditions have a common denominator: they lead to increased peripheral muscle tone secondary to enhanced ␣-motoneuron activity.…”

Effects of intrathecal triamincinolone-acetonide treatment in MS patients with therapy-resistant spasticity

“…There is limited evidence that oral available antispastics like baclofen, diazepam, dantrolene and tizanidine are effective in the treatment of severe spasticity. 5 Baclofen pumps have shown efficacy in the treatment of spasticity. However, invasiveness and higher costs have to be taken into account.…”

“…Baclofen pumps may be restricted to patients with severe disabling spasticity. 5 Another antispastic drug, tetrazepam, has recently been suspended across Europe after severe skin reactions have been observed including Stevens-Johnson syndrome, toxic epidermal necrolysis and drug rash with eosinophilia and systemic symptoms syndrome. 6 Locally administered botolinum toxin may be used focally for muscle groups like hip adductors 7 and its efficacy in treating neurogenic detrusor overactivity has been proven in phase III trials.…”