Treatment of Generalised Spasticity in Hereditary Spinocerebellar Ataxia When Physiotherapy Has Not Provided Complete Relief
Generalised spasticity is a recognised complication of hereditary spinocerebellar ataxia. When an initial course of physiotherapy does not produce full resolution of spasticity, a structured pharmacological step is indicated.
Clinical Context
Spasticity — increased muscle tone or hypertonia caused by upper motor neurone lesions — can lead to muscle stiffness, spasms, and pain. It has been described across multiple subtypes of hereditary spinocerebellar ataxia, including a number of autosomal dominant and autosomal recessive forms.
When Physiotherapy Was Not Enough
First-line physiotherapy — including patient and carer education in correct posture, appropriate muscle use, and avoidance of spasticity triggers — did not achieve complete reduction of spasticity. The protocol below addresses the next management step when this goal has not been met.