WVU Children's Hospital Spasticity Clinic

Children are seen by specialists in pediatric neurology, pediatric neurosurgery, and physical therapy who work together to provide the best treatment plan possible for each child.

Services available at the Spasticity Clinic include:

• oral medications
• evaluation for physical therapy needs
• serial casting
• BOTOX® injections under EMG guidance
• intrathecal baclofen pump placement
• consultation for orthopaedics

What is spasticity?

Spasticity is a disorder that causes muscles tightness or spasm. Spasticity results from damage to the central nervous system (brain or spinal cord) from stroke, traumatic brain injury, tumor, or cerebral palsy.

Spasticity may be a mild feeling of stiffness or tightness in the muscles, or it may be severe and produce painful spasms, joint pain, involuntary rhythmic contractions (clonus), and crossing of the legs (scissoring). The stiffening can be so severe that simple tasks such as walking or getting dressed can be challenging.

What treatment is available?

Many forms of treatment are used to reduce spasticity, depending on the severity and body part affected. Each patient requires individualized treatment. The first step is to evaluate the child to find out what treatment path will be most beneficial.

Oral medications are frequently used to treat spasticity. Common medications include:

• benzodiazepines
• baclofen
• dantrolene sodium
• tizanidine

Clostriduim Botulinum (BOTOX) injections are another available option. BOTOX causes a temporary relaxation or paralysis of the injected muscle. A single injection can give the patient relief from their spasticity for up to three months.

Intrathecal Baclofen Therapy (ITB), otherwise referred to as a Baclofen Pump, uses a surgically implanted pump that slowly infuses the drug Baclofen into the spinal fluid. The drug is delivered in the spinal cord directly to the nerve cells responsible for the spasticity, and therefore, a smaller amount of drug is necessary to achieve muscle relaxation.

Physical Therapy is used to improve function in children with spasticity. The therapist evaluates strength, range of motion, and functional ability and provides the appropriate plan to improve movement and motor function.

Serial Casting, which is used to release contractures and improve range of motion, is offered in collaboration with the School of Medicine Division of Physical Therapy and the Hospital Physical Therapy Service.