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People who have strokes are subject to numerous potentially devastating sequelae, most often sensorimotor paresis, impairment of cognition and language, and other functional disabilities, including depression and dementia. Of these sequelae, spasticity occurring with motor dysfunction is a frequent finding that has to be evaluated in light of other diagnoses, such as central paresis, ataxia, pathologic stance or gait, and other coordination dysfunctions. Often, spasticity is not notably present in acute ischemic strokes but develops later on, and may then become a major obstacle for achieving independence in performance of activities of daily living (ADLs). Spasticity appearing after a stroke demonstrates quite convincingly that stroke is not a stable condition, but must be viewed instead as a dynamic condition that over time can precipitate additional impairments that were not necessarily noted or present in the acute phase. Poststroke spasticity (PSS) can indeed appear immediately after the ictus, but is most often seen later in the course of the illness. It then becomes a marker of changing or increasing sensorimotor malfunction and therefore requires repeated neurologic assessments. PSS can occur coupled with pain, be noted with decreased dexterity or positioning, or simply be associated with a gradual increase in sensorimotor paresis. When occurring late, PSS can induce changes in the entire health perception of the patient and caregiver.
GLOSSARY
- ADLs=
- activities of daily living;
- PSS=
- poststroke spasticity
ACKNOWLEDGMENT
The authors thank Allergan, Inc., for supporting travel and meetings of an advisory group that met over the past 3 years to discuss the many issues of poststroke spasticity. It was found that no concise overview exists on this topic that reflects clinical as well as recent research findings. Therefore, this supplement was planned. Authors Michael Brainin, Bo Norrving, Brett Kissela, Jörg Wissel, David Burke, Geoffrey A. Donnan, Christopher Chen, Didier Leys, Alberto Esquenazi, Katharina S. Sunnerhagen, John Olver, Gerard E. Francisco, and Richard D. Zorowitz did not receive financial compensation or honoraria for contributing to this supplement. Authors Aubrey Manack and Patrick J. Gillard are employees of Allergan, Inc. The authors thank Allergan, Inc., for supporting the costs of production and for funding Imprint Publication Science, New York, NY, to provide editorial support in the preparation of this supplement.
Footnotes
Author disclosures are provided at the end of the article.
This Neurology® supplement was not peer-reviewed. Information contained in this Neurology® supplement represents the opinions of the authors. These opinions are not endorsed by nor do they reflect the views of the American Academy of Neurology, Editor-in-Chief, or Associate Editors of Neurology®.
- © 2013 American Academy of Neurology
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