spasticity diagnosis and management

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Author : Allison Brashear, MD
ISBN : 9781933864518
Genre : Medical
File Size : 83. 23 MB
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This pioneering work defines spasticity in the broad context of Upper Motor Neuron Syndrome and focuses not on a single component, but on the entire constellation of conditions that make up the UMNS and often lead to disability. Spasticity: Diagnosis and Treatment clearly defines the process for the diagnosis of spasticity, the basic science behind its pathophysiology, the measurement tools used for evaluation, and reviews the available treatment options. Divided into five sections, this comprehensive clinical resource provides a roadmap for assessing the complicated picture of spasticity and choosing the appropriate interventions. Therapies including oral medications, intrathecal baclofen, botulinum toxin and phenol, and surgical options are thoroughly discussed, as are non-medical therapies and the role of the emerging technologies. The full spectrum of diseases involving spasticity in adults and children and the unique diagnostic and management challenges they present is addressed by experienced clinicians. This text is a one-stop source for physicians, therapists and other members of the spasticity management team tasked with the goal of improving patient care and outcomes.


Author : Allison Brashear, MD
ISBN : 9781617052422
Genre : Medical
File Size : 21. 9 MB
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Since publication of the first edition, Spasticity: Diagnosis and Management has been the defining reference and go-to source for physicians, therapists, and other healthcare providers who care for patients with spasticity. For this new updated edition, Dr. Brashear and a diverse team of specialists have come together to integrate new research, clinical trials, measurement tools, therapies, and other recent advances that reflect this evolving field. The book is organized into four sections, each of which covers a broad scope of material. The first is a general overview of spasticity and its effects on movement in patients. Other chapters cover epidemiology and ancillary findings commonly associated with spasticity. Part II details assessment tools and measurements, treatment goals, and how to aim for realistic outcomes. Part III outlines various treatment modalities, including heavily updated chapters on the use of botulinum toxin in the upper and lower extremities, guidance techniques for injections, intrathecal baclofen, neuromodulation, surgery, physical therapy, and more. The last section, which contains several new chapters, discusses evaluation of outcomes and management of patients with stroke, traumatic brain injury, spinal cord injuries, multiple sclerosis, cerebral palsy, and cancer, followed by chapters on spasticity management in long-term care facilities and economic considerations. This book remains the most comprehensive guide to diagnosis and management of spasticity in adults and children, and the revised second edition will continue to serve as an invaluable resource for professionals in any discipline who strive to provide quality care to spasticity patients. Key Features: Revised edition of the premier clinical reference on spasticity Incorporates the latest advances in assessment and treatment Contains six entirely new chapters highlighting key topics including Tardieu scale and other measurement tools, ultrasound guidance for botulinum toxin management, spasticity in special populations, emerging therapies, and economic impact More than 200 figures and 70 tables accompany the updated text

Ultrasound Guided Chemodenervation Procedures

Author : Katharine E. Alter, MD
ISBN : 9781617051074
Genre : Medical
File Size : 60. 61 MB
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Ultrasound-Guided Chemodenervation Procedures provides a comprehensive multimedia approach to neurotoxin therapy using ultrasound. This combined text/atlas/DVD offers a complete review of toxin therapy, both current indications and emerging applications, as well as a detailed review of ultrasound technology and ultrasound guidance techniques for botulinum toxin injections and nerve blocks. The work also includes a detailed anatomic and pictorial atlas (print and DVD), which will be invaluable to clinicians performing procedures with or without ultrasound guidance. The text section of the book is a reference manual, covering conditions and indications, chemodenervation agents, and ultrasound basics including essential physics, machine settings, artifacts, scanning techniques, and procedural guidance techniques. The illustrated print and DVD atlas sections offer a stunning visual roadmap for understanding ultrasound anatomy, localizing muscles, and safely and successfully performing chemodenervation procedures. Features of Ultrasound-Guided Chemodenervation Procedures include: More than 1,300 clinical pictures, anatomical drawings, and ultrasound stills Over 300 video clips of structures, injections, and techniques for performingchemodenervation and neurolysis or combination therapies with ultrasound Practical yet comprehensive-an indispensable print and electronic reference for clinicians Review of ultrasound technology, techniques, and clinical applications for chemodenervation Review of clinical indications and emerging uses of botulinum toxin

Fatigue In Multiple Sclerosis

Author : Dr. Lauren B. Krupp, MD
ISBN : 1934559482
Genre : Medical
File Size : 54. 2 MB
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This practical guide for physicians and other health care professionals discusses the impact of fatigue on the individual with MS, the potential etiologies underlying MS-related fatigue, its work up and diagnosis, and pharmacologic and nonpharmacologic management strategies. Fatigue is perhaps the single most prevalent and disabling symptom of the multiple sclerosis, and limits patients' activity more than any other MS symptom. The identification of fatigue as a distinct clinical entity requires both art and science, and most of all, a willingness and ability to listen carefully to patients and their families. The physician's ability to obtain a comprehensive history requires a full understanding of the circumstances in which fatigue occurs (physical, cognitive, and psychosocial) and demands consideration of a large number of disorders, including anxiety, depression, excessive daytime sleepiness, pain, and spasticity, all of which may mimic or contribute to fatigue. While fatigue is almost exclusively a subjective experience, depending on the patient's ability to understand and report this symptom, there are effective methods for identifying the existence of fatigue, determining its severity, and distinguishing it from related or contributing disorders such as depression, pain, and sleep disorders. Readers will learn that fatigue need not be tolerated by the MS patient. Various therapies, support systems, and treatment of underlying affective disorders can all alleviate fatigue or reduce its impact, restoring the patient's energy levels and ability to participate in life. Virtually every MS patient with fatigue can benefit from intervention, and failing to treat the symptom of fatigue with the respect that it deserves is a serious detriment to patient care.

Upper Motor Neurone Syndrome And Spasticity

Author : Michael P. Barnes
ISBN : 9781139471428
Genre : Medical
File Size : 87. 48 MB
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Spasticity is a disabling problem for many adults and children with a variety of neurological disorders such as multiple sclerosis, stroke, cerebral palsy and traumatic brain injury. A practical guide for clinicians involved in the management of spasticity, this book covers all aspects of upper motor neurone syndrome from basic neurophysiology and measurement techniques to practical therapy and the use of orthoses. Surgical techniques are also covered, as well as the particular problems of management of spasticity in childhood. In the second edition of this key text, all chapters have been thoroughly updated, with additional coverage of new techniques and new drugs and therapies, whilst continuing the format that has made the first edition the core text in its field. This guide will be invaluable to physicians, physiotherapists, surgeons, orthotists, clinical engineers and health professionals.

Neurosurgery For Spasticity

Author : Marc Sindou
ISBN : 9783709117712
Genre : Medical
File Size : 70. 81 MB
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The book is devoted to the neurosurgical management of spasticity. Starting with a chapter on the anatomical and physiological foundations of spasticity and a short history of its neurosurgical treatment, it describes the neurosurgical methods currently available. As management differs between adults and children, the book is also structured accordingly, including evaluation, decision-making, Intrathecal Baclofen Therapy (ITB), botulinum toxin therapy and surgery. Beyond ITB, the neurosurgical options covered include procedures focusing on the peripheral nerves, dorsal roots, Dorsal Root Entry Zone and spinal cord. Based on surgical experience collected with more than a thousand patients, the book gathers the most important aspects of our present understanding, presented using a practical, educational approach. It stresses the importance of a multidisciplinary approach, including neurologists, pediatricians and rehabilitation specialists. Close collaboration with other surgical disciplines like orthopedic surgery and neuro-urology are also outlined.

Clinical Evaluation And Management Of Spasticity

Author : David A. Gelber
ISBN : 9781592590926
Genre : Medical
File Size : 68. 70 MB
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David A. Gelber, MD, and Douglas R. Jeffery, MD, have assembled a much-needed collection of authoritative review articles discussing the pathophysiology of chronic neurologic spasticity and detailing its often complex medical and surgical management. Written by leading experts in neurology and rehabilitation, the book covers physical and occupational therapy, splinting and orthotics, electrical stimulation, orthopedic interventions, nerve blocks, the use of botulinum toxin, and novel treatments such as tizanidine, intrathecal medications, and neurosurgical techniques. The contributors also review coordinated approaches to the treatment of spasticity and specific neurological diseases such as spinal cord injury, multiple sclerosis, stroke, cerebral palsy, and traumatic brain injury.

Principles Of Neurological Surgery E Book

Author : Richard G. Ellenbogen
ISBN : 9780323461276
Genre : Medical
File Size : 86. 78 MB
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Perfect for anyone considering or training in this challenging specialty, Principles of Neurological Surgery, 4th Edition, by Drs. Richard G. Ellenbogen, Laligam N. Sekhar, and Neil Kitchen, provides a clear, superbly illustrated introduction to all aspects of neurosurgery–from general principles to specific techniques. Thorough updates from leading authors ensure that you’ll stay abreast of the latest advances in every area of neurosurgery, including pre- and post-operative patient care, neuroradiology, pediatric neurosurgery, neurovascular surgery, trauma surgery, spine surgery, oncology, pituitary adenomas, cranial base neurosurgery, image-guided neurosurgery, treatment of pain, epilepsy surgery, and much more.

Spasticity Management

Author : Valerie Stevenson
ISBN : 0203090543
Genre : Medical
File Size : 64. 17 MB
Format : PDF, Docs
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Spasticity is a common symptom seen in many neurological conditions notably head injury, spinal cord injury, stroke, cerebral palsy and multiple sclerosis. It is also the dominant feature in a number of rarer conditions such as tropical and hereditary spastic paraparesis (HSP). The fact that it is relevant to many chronic neurological conditions and that the absence of multi-disciplinary input can result in progressive disability, ensures spasticity management is a prominent feature in the current National Service Framework (NSF) for long term neurological conditions. In the future more long-term care for such patients will be done in primary care and the community. It is therefore essential that a multi-disciplinary approach is used with successful liaison between secondary, primary and social care. Optimum management of spasticity is dependent on an understanding of its underlying physiology, an awareness of its natural history, an appreciation of the impact on the patient and a comprehensive approach to minimising that impact which is both multi-disciplinary and consistent over time. Regrettably, these essential requirements are rarely met and consequently, inadequately managed spasticity results in a range of painful and disabling sequelae, which, with the right approach, are, for the most part, preventable. Although there are several excellent publications looking at this area, none are a truly practical guide relevant to all members of the multi-disciplinary team involved in spasticity management. Anyone who has been involved in setting up a new service knows how difficult and how protracted a process this can be and if it has been done before, why reinvent it? The basis of this manual is to collect together the experience and knowledge of such a team who have worked in this area for 10 years now. It pulls together all areas including how to set up and develop a service as well as useful management strategies. On a practical note it includes complete copies of all of our patient information, assessment proformas, protocols for different interventions, nursing care plans and an integrated care pathway for outpatient spasticity management both as hard copy but also on CD-ROM to aid in reproduction. These protocols are of course specific to our team but could easily be adapted for use in other centres. We are not saying this is the 'right' or only way to run a spasticity service and there is certainly room for improvement, but we hope by sharing our experience we can help others to develop their own service thus improving management for all individuals with spasticity.

Managing The Symptoms Of Ms

Author : Randall T. Schapiro, MD, FAAN
ISBN : 9781617052187
Genre : Health & Fitness
File Size : 68. 78 MB
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The fully updated and revised sixth edition of the definitive guide to clinically tested and proven methods for effectively managing all of the symptoms characteristic of MS and MS treatment. Based on the most up-to-date disease management strategies, medical and research breakthroughs, and latest drug therapies, Dr. Randall T. Schapiro provides the information you need to manage both the disease and symptoms, and make everyday life easier. New chapters offer essential advice for those newly diagnosed with the disease, and those who experience more symptoms with age. Managing the Symptoms of Multiple Sclerosis features comprehensive treatment options for: Fatigue Spasticity Tremor Incontinence Speech and swallowing difficulties Pain Numbness Cognitive difficulties

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