O'Brien C F, Seeberger L C, Smith D B
Movement Disorders Center, Colorado Neurological Institute, Englewood, USA.
Drugs Aging. 1996 Nov;9(5):332-40. doi: 10.2165/00002512-199609050-00004.
Spasticity following stroke reflects a spectrum of clinical problems including increased muscle tone, abnormal limb posture, excessive contraction of antagonist muscles and hyperactive cutaneous and tendon reflexes. The prevalence of stroke-related disability in stroke survivors is high, and spasticity may be a significant component of this. Management strategies include a multidisciplinary team approach utilising a variety of rehabilitation techniques. Although some interventions are well tolerated and fairly standardised, older adults may be particularly sensitive to drug treatment-related adverse effects. This article reviews some of the commonly employed interventions, such as oral medications, and some of the newer techniques, such as intrathecal baclofen infusion and botulinum toxin injections. The optimal management of spasticity following stroke in older adults requires careful goal setting and skilful combination of treatment modalities in order to produce the best outcome.
中风后的痉挛反映了一系列临床问题，包括肌张力增加、肢体姿势异常、拮抗肌过度收缩以及皮肤和腱反射亢进。中风幸存者中与中风相关的残疾患病率很高，而痉挛可能是其中的一个重要因素。管理策略包括采用多学科团队方法并运用多种康复技术。尽管一些干预措施耐受性良好且相当标准化，但老年人可能对药物治疗相关的不良反应特别敏感。本文回顾了一些常用的干预措施，如口服药物，以及一些较新的技术，如鞘内注射巴氯芬和肉毒毒素注射。为了取得最佳效果，对老年人中风后痉挛的最佳管理需要仔细设定目标并巧妙地组合治疗方式。
