title: Pharmacologic treatment of spasticity in children.
abstract: Many clinicians frequently face the dilemma of whether and how to medically treat spasticity. When pharmacologic intervention is deemed appropriate, treatment decisions must first be based on accurate assessment using valid and reliable clinical instruments, and, importantly, specific, measurable, achievable, and realistic treatment goals should be delineated. For the treatment of localized or segmental spasticity, botulinum toxin (BoNT-A) is recommended as an effective and generally safe treatment. For more generalized spasticity, a number of useful oral agents and intrathecal baclofen are available, each with their positive and negative attributes. Fundamental knowledge of pharmacologic properties and toxicities of these medications is required for safe and appropriate use. To achieve optimum results, spasticity treatment should be part of an integrated therapeutic approach in which patients, caregivers, therapists, physicians, and surgeons have an open and clear communication about the overall rehabilitation process of the patient. This review summarizes the current pharmacologic approaches to spasticity treatment in children, critically evaluating published studies in the context of established evidence-based criteria.
authors.affiliation: Louisiana State University, New Orleans, LA, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Tilton
authors.forename: Jilda
authors.initials: J
authors.lastname: Vargus-Adams
authors.forename: Mauricio R
authors.initials: MR
authors.lastname: Delgado
mesh_terms: D000367:Age Factors; D001418:Baclofen / Q000008:administration & dosage / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D002648:Child; D003000:Clonidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003620:Dantrolene / Q000627:therapeutic use; D003975:Diazepam / Q000627:therapeutic use; D006801:Humans; D007278:Injections, Spinal; D009128:Muscle Spasticity / Q000175:diagnosis / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D009465:Neuromuscular Agents; C023754:tizanidine; D001905:Botulinum Toxins; D003620:Dantrolene; D001418:Baclofen; D003000:Clonidine; D003975:Diazepam