International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, Maryland.
The Centre for Family Medicine Family Health Team, Kitchener, Ontario.
Top Spinal Cord Inj Rehabil. 2020 Summer;26(3):157-165. doi: 10.46292/sci2603-157.
Muscle spasticity is a common sequela of spinal cord injury (SCI) that may impact daily function. Spasticity dynamically varies and is an important physiologic response to illness or other stressors. The challenge for the general practitioner is in recognizing, treating, and developing an effective plan focused on the patient's individual goals. To provide the general practitioner with a basic contextual, diagnostic, and therapeutic approach to spasticity management for individuals with neurologic injury such as SCI. Muscle spasticity can be disabling and can be managed effectively by using a comprehensive approach. We discuss a representative case and the assessment and planning for individuals with SCI and spasticity. Through an understanding of pathophysiology, careful history taking, and physical exam, a cause for increased spasticity can be identified, such as infection, constipation, or pregnancy. Symptomatology of these triggers is often quite different in the SCI population than in the general population. Management includes the treatment of this causative stressor as well as the thoughtful management of spasticity itself. Muscle spasticity is dynamic and requires a patient-centered approach. The general practitioner can play a key role in recognizing and treating spasticity in an individual with SCI. Comprehensive management to meet patient and caregiver goals involves primary care providers, specialists, and allied health practitioners.
肌肉痉挛是脊髓损伤 (SCI) 的常见后遗症，可能会影响日常功能。痉挛是动态变化的，是对疾病或其他应激源的重要生理反应。全科医生的挑战在于识别、治疗和制定一个以患者个人目标为重点的有效计划。 为全科医生提供一种基本的上下文、诊断和治疗方法，以管理患有神经损伤（如 SCI）的个体的痉挛。 肌肉痉挛可能导致残疾，可以通过综合方法有效管理。我们讨论了一个有代表性的病例，以及对 SCI 和痉挛患者的评估和计划。通过了解病理生理学、仔细的病史采集和体格检查，可以确定导致痉挛增加的原因，例如感染、便秘或怀孕。这些诱因的症状在 SCI 人群中与一般人群中的症状非常不同。管理包括治疗这种致病应激源以及对痉挛本身的深思熟虑的管理。 肌肉痉挛是动态的，需要以患者为中心的方法。全科医生可以在识别和治疗 SCI 患者的痉挛方面发挥关键作用。全面的管理以满足患者和护理人员的目标涉及初级保健提供者、专家和辅助健康从业者。
