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Managing Post-Stroke Spasticity

Chris Boulias, Assistant Professor, Consultant Physiatrist, West Park Healthcare Centre

Spasticity is a functionally limiting disorder that may occur after stroke or brain injury. Post-stroke spasticity (PSS) in combination with other clinical signs and symptoms of the upper motor neuron syndrome such as weakness and lack of coordination, if left untreated, may result in costly complications. PSS management should be guided by improvement in function, decrease in burden of care and prevention of complications rather than a decrease in hypertonicity and improvement in the range of motion of a particular joint. In tandem with neurorehabilitation, chemodenervation with botulinum toxins is the first line treatment for focal spasticity, which is commonly observed post stroke. In this presentation I will touch on the assessment of PSS and I will discuss the pharmacological and non-pharmacological treatment options that are currently available. I will also cover the challenges in the treatment of PSS in patients receiving anticoagulants. The session will be of value to physiatrists, resident and medical students.

At the end of the session, participants will be able to:

  • Recognize the importance of goal setting in the assessment of post-stroke spasticity
  • Summarize the pharmacological and non-pharmacological treatments of post stroke spasticity
  • Discuss the challenges in the treatment of the anticoagulated patient with spasticity
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