I don't think that my spasticity is bad enough to even consider surgery. We need less drastic solutions. May have to look into hyaluronidase.
Abstract
This article presents 2 recent articles that propose novel interventions for treating spastic
hemiparesis
by changing biological infrastructure. In 18 patients with unilateral
spastic arm paralysis due to chronic cerebral injury greater than 5
years’ duration, Zheng et al transferred the C7 nerve from the
nonparalyzed side to the side of the arm that was paralyzed. Over a
follow-up period of 12 months, they found greater improvement in
function and a reduction of
spasticity compared to rehabilitation alone. Using
functional magnetic resonance imaging,
they also found evidence for physiological connectivity between the
ipsilateral cerebral hemisphere and the paralyzed hand. In the second
article, Raghavan et al examine the concept of stiffness, a common
symptom in patients with spastic hemiparesis, as a physical change in
the infrastructure of muscle. Raghavan’s non-neural
hyaluronan
hypothesis postulates that an accumulation of hyaluronan within spastic
muscles promotes the development of muscle stiffness in patients with
an upper motor neuron syndrome (UMNS). In a case series of 20 patients
with spastic hemiparesis, Raghavan et al report that
upper limb intramuscular injections
of hyaluronidase increased passive and active joint movement and
reduced muscle stiffness. Interventions that change biological
infrastructure in UMNS is a paradigm on the horizon that bears watching.
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