ABSTRACT
Often by ensuring that there is an effective physical management plan in place and by avoiding trigger factors, an individual’s spasticity can be managed appropriately without pharmacological or surgical input. However, if this is not the case and spasticity is a particularly focal problem, there are specific strategies available other than oral medication: these include botulinum toxin, focal chemical neurolysis or neurotomies. Similarly, some individuals, although they have a generalised picture that is in the most part being effectively managed with oral medication, are still troubled by a focal problem such as a spastic foot drop that is interfering with function. In such individuals, additional focal treatment can be extremely beneficial and may avoid escalation of oral medication with potential side-effects.
