Müller / Penn / Zierski Local-spinal Therapy of Spasticity

1. Auflage 1988
ISBN: 978-3-540-18295-5
Verlag: Springer Berlin Heidelberg

Müller / Penn / Zierski Local-spinal Therapy of Spasticity

Historical photograph of spinal anaesthesia In 1884 the American neurologist J. L. eases. His discovery, however, marks the Corning, by blocking the neural con­ onset of the era of regional anaesthesia. It took almost one hundred years until his duction to the hind extremities of a dog by injecting cocaine-solution into the lumbar original idea of "local medication of the vertebral interspace, was the first to per­ cord" was again reconsidered due to two form spinal (or epidural?) anaesthesia [1]. reasons: At that time, he was unaware of the local I. The discovery of different drug receptors anaesthetic properties of cocaine (dis­ in the spinal cord made it possible, by in­ covered in the same year by C. Koller, who trathecal injection (or epidural appli­ cation, if the drug penetrates the dura), applied cocaine to the eye of one of his pa­ tients [3]) and did not intend to introduce to alter nociceptive or motor transmis­ an anaesthetic procedure. Corning's pri­ sion within the spinal cord. mary aim was the application of drugs in 2. Implantable devices for long-term appli­ proximity of the central nervous system, i. e. cation of drugs to specific sites of the spinal cord, in order to treat or even heal body, including the spinal spaces, were developed during the 1970's.

Zielgruppe

Research

Autoren/Hrsg.

Müller, Hermann

Penn, Richard D.

Zierski, Jan

Inhaltsverzeichnis

Preface.- Preface.- A Short Historical Review of Spasticity and Its Therapy.- A Short Historical Review of Spasticity and Its Therapy.- Basic Experiences.- Spinal Pharmacology of Agents which Alter Pain Transmission and Muscle Tone.- The Neuropharmacology of Baclofen.- Animal Experiments on the Spinal Action of Midazolam.- Intrathecal Injection of Antispastic Drugs in Rats: Muscle Relaxant Action of Midazolam, Baclofen, 2-Aminophosphonoheptanoic Acid (AP7) and Tizanidine.- CSF Compatibility of Antispastic Agents.- Dural Permeability to Bupivacaine, Baclofen and Midazolam: In Vitro Determination with Human Dura Mater.- Clinical Studies.- Pharmacotherapy of Spasticity.- Pumps in Pharmacotherapy.- Implantation of Ports and Pumps. Technique for Intrathecal Administration of Drugs.- Control of Spasticity with Intrathecal Morphine Sulfate.- Clinical Experience with Spinal Morphine, Midazolam and Tizanidine in Spasticity.- Chronic Intrathecal Baclofen for Severe Rigidity and Spasms.- Intrathecal Baclofen in Spasticity.- Chronic Intrathecal Administration of Baclofen in Treatment of Severe Spasticity.- Pharmacokinetics of Intrathecal Baclofen.- Intrathecal Baclofen in tetanus.- The Value of Spinal Cord Stimulation (SCS) in Treatment of Disorders of the Motor System.- Physostigmine Reversal of Baclofen-induced Sedation.- Surgical Treatment of Spasticity- A Review.