Next Article in Journal
Stereotactically Standard Areas: Applied Mathematics in the Service of Brain Targeting in Deep Brain Stimulation
Previous Article in Journal
The Role of Transcranial Direct Current Stimulation (tDCS) in Tourette Syndrome: A Review and Preliminary Findings
Article Menu

Export Article

Open AccessReview
Brain Sci. 2017, 7(12), 162; https://doi.org/10.3390/brainsci7120162

Spasticity Management in Disorders of Consciousness

Coma Science Group, GIGA Research (Interdisciplinary Cluster for Applied Genoproteomics)–GIGA Consciousness & Neurology Department, University and University Hospital of Liege, 4000 Liege, Belgium
*
Author to whom correspondence should be addressed.
Received: 11 October 2017 / Revised: 6 December 2017 / Accepted: 7 December 2017 / Published: 9 December 2017
Full-Text   |   PDF [926 KB, uploaded 9 December 2017]   |  
  |   Review Reports

Abstract

Background: Spasticity is a motor disorder frequently encountered after a lesion involving the central nervous system. It is hypothesized to arise from an anarchic reorganization of the pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected muscular groups. While this symptom and its management is well-known in patients suffering from stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management in patients presenting disorders of consciousness after brain damage. Objectives: Our aim was to review the occurrence of spasticity in patients with disorders of consciousness and the therapeutic interventions used to treat it. Methods: We conducted a systematic review using the PubMed online database. It returned 157 articles. After applying our inclusion criteria (i.e., studies about patients in coma, unresponsive wakefulness syndrome or minimally conscious state, with spasticity objectively reported as a primary or secondary outcome), 18 studies were fully reviewed. Results: The prevalence of spasticity in patients with disorders of consciousness ranged from 59% to 89%. Current treatment options include intrathecal baclofen and soft splints. Several treatment options still need further investigation; including acupuncture, botulin toxin or cortical activation by thalamic stimulation. Conclusion: The small number of articles available in the current literature highlights that spasticity is poorly studied in patients with disorders of consciousness although it is one of the most common motor disorders. While treatments such as intrathecal baclofen and soft splints seem effective, large randomized controlled trials have to be done and new therapeutic options should be explored. View Full-Text
Keywords: spasticity; pain; upper motor neuron syndrome; disorders of consciousness; brain injury; treatment spasticity; pain; upper motor neuron syndrome; disorders of consciousness; brain injury; treatment
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Martens, G.; Laureys, S.; Thibaut, A. Spasticity Management in Disorders of Consciousness. Brain Sci. 2017, 7, 162.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Brain Sci. EISSN 2076-3425 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top