South Shore Neurologic Associates, PC has been providing services to individuals that suffer from spasticity since 1980. The Comprehensive Spasticity Care Center at South Shore Neurologic Associates, PC provides a full range of specialized, interdisciplinary care for individuals with spasticity that helps ensure optimal outcomes. We work collaboratively to improve patient care and enhance quality of life.
Spasticity is a common and debilitating condition experienced by individuals who suffer from stroke, multiple sclerosis, spinal cord injury, brain injury, cerebral palsy amongst other neurological conditions. It can range from slight muscle stiffness to permanent shortening of the muscle. Spasticity can affect the trunk, neck, face or even throat muscles.
Spastic Muscles do not work effectively, appropriately, reliably or consistently. It can interfere with movement, balance, and coordination, as well as comfort, care, cosmesis, hygiene, transferring ability, independence, activities of daily living, can cause pain, and ultimately contractures (shortening and hardening of muscles).
Goals in the Treatment of Spasticity
- Relieve the signs and symptoms of spasticity and spasms
- Reduce pain, frequency of spasms
- Improve voluntary active motor function
- Increase independence
- Enhance ease of care
- Improve overall quality of life
- Provide compassionate care and promote empowerment
Our Treatment Approach
- Medical assessment and identification of treatment needs and goals
- Physical Therapy
- Functional Electric Stimulation and Prosthetics
- Pharmacotherapy (i.e. Baclofen, Tizanidine, Klonopin, Dantrolene)
- Neuromuscular Blockade (i.e. Botulinum toxin, Myobloc)
- Inthrathecal Baclofen Therapy (ITB)
What is Botulinum Toxin?
Botulinum Toxin is a protein produced by bacterium. Botulinum Toxin is one of the most researched neurotoxins in the world and is approved for medical use in 75 countries. Botulinum Toxin treatment is an effective therapy that has been used to treat patients with spasticity for over 20 years.
How does Botulinum Toxin work?
An intramuscular injection of Botulinum Toxin reduces spasticity by blocking signals that tell the muscle to contract. Because the effects of Botulinum Toxin are local, dose dependent, and temporary, this treatment is best utilized in those patients who have specific problem muscles that interfere with major functional aspects of living.
What can I expect from my Botulinum Toxin Treatments?
Botulinum Toxin treatment will consist of a number of injections into the muscles. The amount of Botulinum Toxin and location of the injections will depend on individual needs. After injections, you may begin seeing improvements in your symptoms within 7-10 days. Injections will be administered every 3-4 months, dependent upon results
Does Botulinum Toxin treatment hurt?
The needles used to administer Botulinum Toxin treatment are very fine, so most people experience only mild discomfort.
Is the Botulinum Toxin used for my spasticity the same as the cosmetic Botulinum Toxin?
Yes, both Botulinum Toxin products are the same formulation. However, the dosing and location of the injections carry different results for spasticity and cosmetic Botulinum Toxin.
ITB is a safe and effective therapy for treatment of spasticity. This therapy can be utilized when other therapies have not provided sufficient gains or as a first line treatment if clinically appropriate. The therapy effectiveness is evaluated by use of a test dose. If the gains from the test dose are satisfying then permanent ITB therapy is recommended.
ITB Therapy uses a surgically implanted programmable pump and catheter to deliver medication which helps relieve severe spasticity. This medication goes directly into the intrathecal space where fluid flows around the spinal cord. The components of an ITB system include a pump implanted under the skin on the abdomen which infuses the medication, a catheter which delivers the drug to the spinal cord; and a programmer which allows for adjustable and precise dosing. The ITB therapy program at South Shore Neurologic Associates, PC serves as a national training site for other medical facilities interested in ITB.
How is ITB Therapy different from taking oral baclofen?
When oral baclofen is taken it enters the bloodstream and then crosses into the fluid that surrounds the brain and spinal cord. ITB Therapy delivers baclofen directly into the fluid-filled area surrounding the spinal cord. This requires a lower dose of medication and fewer side effects.
What is involved in ITB maintenance?
Following the surgical implantation of the pump, follow-up maintenance is required every 3-6months dependent on your individual needs.
Will people be able to see that I have a pump?
Depending on your size, shape and where the pump is located, it may not show at all. Your pump will be placed near the surface of your skin for easy refill access.