Spasticity refers to continuous, involuntary muscle contractions following damage to the brain or spinal cord. These contractions may interfere with movement, speech, gait, and general motor functions, affecting quality of life.
Spasticity may occur in association with:
- Brain trauma
- Cerebral palsy
- Multiple sclerosis
- Spinal cord injury
Spasticity may occur with some metabolic disorders as well as other medical conditions.
Mount Sinai offers several means of treating spasticity:
- Rehabilitation therapy. Mount Sinai provides both physical and occupational therapy to treat spasticity.
- Medications. These include: baclofen (oral or via a pump implanted into the spinal canal [intrathecal]), diazepam, tizanidine, or clonazepam. However, these medications are systemic and often carry significant side effects, including sleepiness, headache, and nausea.These side effects make it difficult to achieve optimum rehabilitation.
- Surgery. Surgery may be performed to release tendons or sever the affected nerve-muscle pathways. However, these procedures are invasive, costly, and at times debilitating.
- Botulinum toxin injections (chemodenervation). Botulinum toxin is an excellent minimally invasive treatment with a low risk of side effects. Treatment is targeted, thereby avoiding the potential complications caused by systemic medications or surgery. The successful treatment of spasticity with botulinum toxin requires specialized education in proper assessment, dosing, and injection techniques. Mount Sinai spasticity specialists are accomplished in all of these areas.
Meet our team
Mount Sinai physicians who specialize in spasticity include:
- David M. Simpson, MD. Dr. Simpson is Director of the Clinical Neurophysiology Laboratories and Director of the NeuroAIDS Program at The Mount Sinai Hospital. Dr. Simpson is the principal investigator for many studies, including the treatment of spasticity with botulinum toxin, management of pain in patients with peripheral neuropathy, and the diagnosis and treatment of patients with neurological complications of HIV/AIDS. Dr. Simpson is frequently listed among Castle Connolly’s Top Doctors in the New York Metro Area, New York Times Super Doctors, and New York magazine’s Best Doctors in New York. He lectures extensively internationally in his fields of expertise.
- Barbara Kelly Changizi, MD, Assistant Professor of Neurology, is Co-Director for the Center of Neuromodulation at Mount Sinai Medical Center. She provides expertise on deep brain stimulation (DBS) as a treatment for movement disorders such as Parkinson disease, tremor, and dystonia. She did a fellowship in movement disorders at the Parkinson’s Disease and Movement Disorders Center at Albany Medical Center, and was Assistant Professor there until joining the faculty at Mount Sinai.
- Thomas N. Bryce, MD. Dr. Bryce is Medical Director of Mount Sinai’s Spinal Cord Injury Program and Mount Sinai’s Rehabilitation Ambulatory Services. Dr. Bryce combines leading-edge techniques, such as fluoroscopically guided spinal injections, intrathecal pump management, and botulinum toxin injections, with proven traditional methods, such as individually designed physical therapy programs, to provide patients with the best rehabilitation and pain management possible.
- Michael R. Hausman, MD. Dr. Hausman is the Robert K. Lippmann Professor of Orthopaedic Surgery and Vice-Chair of the Department of Orthopaedics. Dr. Hausman is an internationally recognized upper extremity surgeon who treats disorders of the hand, elbow, shoulder, and peripheral nerves. Castle Connelly and New York Magazine have recognized him as one of the nation’s and one of New York City’s top doctors.
Talk to your physician about whether the above therapies may help you. For referral appointments, please call neurologists David M. Simpson, MD, at 212-241-8748, Mark A. Sivak, MD, at 212-241-7076, or Jessica Robinson-Papp, MD, at 212-241-8390; or call the Robert and John M. Bendheim Parkinson & Movement Disorders Center at 212-241-5607 to schedule an appointment.
David M. Simpson, MD
Barbara Kelly Changizi, MD
In this “Healthy Body Healthy Mind” video, airing on PBS, Mount Sinai’s David M. Simpson, MD, discusses spasticity in stroke survivors. View Video
In this New York Times article, Mount Sinai’s David M. Simpson, MD, discusses how Botox can relax the muscles of stroke survivors. Read More