From the FDA Drug Label
Tizanidine is a short-acting drug for the management of spasticity. The management approach for spasticity in patients with cerebral palsy involves using drugs like tizanidine to help relieve spasticity, especially during daily activities and times when relief is most important.
- Key points:
- Tizanidine is used for the management of spasticity
- It is a short-acting drug
- Treatment with tizanidine should be reserved for those daily activities and times when relief of spasticity is most important 1
From the Research
The management of spasticity in cerebral palsy requires a multidisciplinary approach combining physical therapy, oral medications, focal interventions, and sometimes surgery, with the goal of improving morbidity, mortality, and quality of life. This approach is supported by various studies, including 2, which highlights the effectiveness of selective dorsal rhizotomy (SDR) in reducing spasticity in selected children with cerebral palsy.
Key Components of Spasticity Management
- Physical therapy: forms the foundation of treatment, with regular stretching exercises and positioning techniques to maintain range of motion and prevent contractures
- Oral medications: first-line options include baclofen, diazepam, and dantrolene sodium, which can help reduce spasticity and improve functional capacity
- Focal interventions: botulinum toxin injections can provide temporary relief for focal spasticity, while intrathecal baclofen therapy can be effective for severe, diffuse spasticity
- Surgery: orthopedic surgery may be necessary for fixed contractures, while SDR can permanently reduce spasticity in carefully selected patients
Individualized Treatment Approach
Treatment should be tailored to the individual patient's needs, taking into account their age, functional goals, distribution of spasticity, and associated conditions. As noted in 3, a multidisciplinary approach is essential, and treatment should be initiated at low dosages and gradually increased to avoid adverse effects.
Recent Advances and Recommendations
The most recent study, 2, highlights the effectiveness of SDR in reducing spasticity in children with cerebral palsy, and supports the use of a minimally invasive approach to SDR. Intrathecal baclofen therapy, delivered via an implanted pump, is also a recommended option for severe, diffuse spasticity, as it can provide significant relief and improve quality of life. Overall, a comprehensive and individualized approach to spasticity management is crucial for improving outcomes in patients with cerebral palsy.