Drug rehabilitation paralysis after Stroke

After Stroke patients often sequelae paralysis. Approximately 60% of patients with sequelae of this. Among the 5% upper limb spasticity can be recovered partially functional. The rigidity of this loss of dexterity, affect motor function for patients. Some medications can help improve the situation: prescribe muscle relaxants, neuromuscular blockers, latest toxin injection botolotoxin blocking the release of acetylcholine. Using medication relaxes muscles Medications are baclofen, diazepam dantrolen ... downside of this method is, by non-selective drugs on the paralyzed limb, it can reduce the normal muscle (such as muscle weakness themselves should hard to sit). Long-term use will habituation, to increase the dose, or lead to "drug dependence". With the drug baclofen: initially been studied with the aim of curing epilepsy, but no response, whereas effective in spastic muscles. In children, the high dose (compared with age) new efficiency, but high doses have harmful side effects than benefits, so it is not used. Currently baclofen only for adults to relax muscles after Stroke. Advantages of the drug does not cause the accumulation of the drug, the patient can be prolonged use without fear of withdrawal symptoms when stopping the drug. However, after a period of prolonged use, the drug used, the effect is somewhat diminished. Baclofen effective spinal injections stable than drinking, but this technique is difficult, prone to infections. How to drink and still commonly used (but with a little unstable performance). At therapeutic dose and duration of treatment suitable rarely cause drug dependence. When high doses, stretching will cause the symptoms: hallucinations (auditory, visual, tactile), paranoia, anxiety, confusion, impairment fluctuations; distracting thoughts, loss of self-control, mood disorders, behavior disorders, madness; sympathetic disorder (hyperthermia, tachycardia, tremors) specifying a reverse reactions (increased muscle tone, muscle cramping feedback, extreme muscle rigidity). Do not use baclofen for seizures, kidney failure, liver failure, respiratory failure, a history of stomach ulcers, pregnant women breastfeeding (due to incomplete information). It inhibits CNS should not be used when driving operators to work at height or other ventures. To avoid side effects should be examined periodically for physicians to adjust the dose as needed. + Dantrolen phenytoin derivatives are also being studied for the treatment of epilepsy (1963), but no effect was then proposed as a muscle relaxant drugs (in 1967). Dantrolen muscle relaxation (reduced muscle) by eliminating stimulation of the muscle cells, possibly through effects on receptor ryanodin reduction in the intracellular calcium concentration. Because this effect is used in muscle spasticity after a stroke on the brain. The advantage of the drug is not effective on neurotransmitters, so no local anesthetic effect, no effect on nerve - should not cause muscle paralysis like Cura; no malignant hyperthermia (often seen in other neurological inhibitors) which is not only beneficial when used in the treatment of muscle spasticity, but also useful when used with synthetic anesthetics (anesthetic aggregate phenomenon causing hyperthermia). However, the drug can cause visual disturbance, psychosis, depression, headaches, insomnia, nervousness, hallucinations, arthritis, seizures, more rarely respiratory insufficiency, suffocation ; failure of the sense of taste, loss of appetite, nausea, diarrhea, cramps (abdominal). Also possible impacts pericarditis (the drink), with the cardiac transient response; bone marrow damage (rare), diffuse muscle pain, muscle weakness (lasting only a few days); back pain, urinary crystals (rare) ... Do not use dantrolen to severe hepatic impairment, severe heart failure, damage and respiratory failure, muscle spasticity level, pregnant lactating (by incomplete information). It inhibits CNS, do not use when driving, operating machinery, working on high or other ventures. Using alcohol or phenol neuromuscular blockers This method has the disadvantages of causing loss of feeling and then feel disorder. The effect lasted only a few months. Booster will be difficult and inefficient due to fibrous tissue surrounding the nerve altered. Use Botolotoxin toxin (Conservation-A) blocking the release of acetylcholine The principle of the method: selective injection into the muscle spasticity, BoTNA inhibits the release of acetylcholine at the neuromuscular prevent neuromuscular transmission, reduces muscle spasticity. Do topical, low doses, selective, BoTNA not cause muscle hypotonia general movement of the body, is quite safe (since no effect on the whole body). However this is a difficult technique for injection technique must be in place. The injection must understand anatomy, assess the degree of hazard and dose probe (only dose sufficient to cause muscle relaxation as you wish). Show botolotoxin many kinds, with different toxicities and different content. Type is used for anti-paralysis botolotoxin A (BoTNA). If sequelae palsy (spastic muscles) outpatient treatment, the muscle relaxant medication use is appropriate (for the majority), and the method by blocking toxins BoTNA but highly effective and secure the applies only in the hospital, usually in hospitals. Patients not arbitrarily by nurses about drug injection downline households (because very dangerous).