Severe spasticity is a common symptom in patients with neurological disorders and represents a major clinical challenge to health care professionals.

The disabling effects of spasticity can interfere with the activities of daily living and lead to a myriad of complications, including pain, impaired mobility, sleep disruption, depression, progressive scoliosis, and contractures. Real-world cases of spasticity are often more complex than classical textbook descriptions, making appropriate diagnosis and treatment planning challenging and frustrating for both patients and clinicians.

The Alta Bates Summit Spasticity Management Program meets the challenges of providing up-to-date, multidisciplinary and comprehensive care for these patients.

A Multidisciplinary Team Approach
The Alta Bates Summit Spasticity Management Program is a truly multidisciplinary team. It features the combined expertise and experience of multiple specialists:

• Rehabilitation Nurse Practitioner Barbara Ridley, RN, FNP coordinates the team. Ms. Ridley has gained national recognition for her expertise in this field, serving as faculty in national training programs on the management of intrathecal baclofen. Ms. Ridley coordinates the spasticity management program.
  
  
• Alta Bates Summit physiatrists Hussam El Gohary, MD; Herb Goodman, MD;, Dougal MacKinnon, MD; and Rhonda Caldwell-Williams, M.D. lead the rehabilitation team that includes physical therapists, occupational therapists, speech pathologists and neuropsychologists.
  
  
• Neurologist Joanna Cooper, MD of Sutter East Bay Medical Foundation Neurology who administers Botulinum toxin in selected patients and performs the test dose of intrathecal baclofen, in addition to providing input on medical management
  
  
• Gordon Tang, MD of East Bay Neurosurgery and Spine, who does the implantation of intrathecal devices.
  
  
• Eric Gaensler, MD from Neuroradiology who assists in trouble-shooting diagnostics as needed.

Treatment Options
Mild cases of spasticity often respond well to conservative treatment approaches that may include one or more of the following:

• Well-established, FDA approved antispastic oral medications such as baclofen, dantrolene, tizanidine, or gabapentin, as well as non FDA-approved medications
  
• Physical medicine modalities such as stretching, positioning, cryotherapy, splinting or inhibitory casting
  
• Reduction of factors such as poor positioning, pressure from devices or recurrent infections that may increase spasticity.

For patients with more severe cases of spasticity, Alta Bates Summit offers several additional treatment options, including:

• Botulinum toxin injections or motor nerve point blocks
  
• Intrathecal Baclofen (ITB) Therapy (also called the Baclofen Pump) approved by the FDA for treating spasticity of both spinal cord and cerebral origin.

Established in 1996, the Alta Bates Summit ITB Program has become one of the largest in the state and is a recognized Center of Excellence for this therapy.

A Special Note about ITB Therapy
ITB Therapy works by injecting Baclofen via a catheter directly into the cerebrospinal fluid surrounding the spinal cord. The catheter connects to an infusion pump implanted under the skin of the abdomen.

Because the delivery of drug is direct to the site of action, patients achieve relaxation with very small doses – as little as 1/100th of the typical oral dose. This increases effectiveness and helps reduce undesirable side effects such as drowsiness and weakness, common with oral antispastic medications.

Contact Us
For more information about the program, please contact Barbara Ridley, RN, FNP, Spasticity Program Coordinator at (510) 204-5259.

What Our Patients Say:

“I received outstanding care…didn’t even feel the needle.”
- Patient

“I see a big difference in the sensation in my legs.”
- Patient