Spasticity: A general outlook of pathogenesis and current management

Spasticity is an upper motor neuron disorder demonstrated by a velocity-dependent increased muscle tone, clonus, spastic dystonia or tonic stretch hypertonia. It is seen in conditions, such as traumatic brain and spine injury, stroke, hypoxic brain damage multiple sclerosis, degenerative diseases etc. The incidence of spasticity remains variable amongst different conditions. For example, in stroke patients, about 38-40% of patients would develop some degree of spasticity with about 16% requiring treatment. Incidence varies from between 27% in acute-subacute phase to about 42.6% per month in the chronic phase (> 3 months). Furthermore, there is an estimated 40%patients with spinal cord injury living with spasticity with some data estimating a higher figure (78%). Management of this condition which impact patients and caregivers are therefore of essence. Currently there are various treatment modalities available for management. The aim of this review is to discuss the pathophysiology, experimental studies of spasticity and to highlight various therapeutic strategies for management of spasticity.