ABSTRACT
Spasticity has been defined as a velocity-dependent increase in resistance to passive muscle stretching due to the exaggeration of tonic stretch reflexes1. Spasticity is frequently encountered in patients with multiple sclerosis (MS), often with significant consequences. In a prevalence study of 301 MS patients, 52% reported cramps, and 56.5% had increased tone on examination2. In a recently published survey of over 20 000 individuals with MS, only 16% of responders reported no spasticity, and approximately 33% reported moderate or severe spasticity, despite ongoing symptomatic treatment in a majority of these patients3. Disease-modifying therapies usually do not provide symptom relief, and there are even reports of increased spasticity with interferon β4. Although the pathophysiology of spasticity is incompletely understood, a wide array of symptomatic therapies are available to the clinician.
