Clinical Scenario

Treatment of Multiple System Atrophy with Spasticity

Multiple system atrophy (MSA) is a progressive neurological condition that can present with spasticity — a motor disorder characterised by a velocity-dependent increase in muscle tone or tonic stretch reflexes associated with hypertonia.

Presenting Condition

Spasticity in MSA arises from disruption of upper motor neuron pathways, producing abnormal muscle tone that becomes more pronounced with the speed of passive limb movement. This feature requires targeted management distinct from the broader treatment of MSA itself.

Treatment Approach

Management of spasticity in multiple system atrophy involves pharmacological agents that act on muscle tone, alongside structured rehabilitative interventions. The selection of specific agents and the sequencing of therapies depend on individual patient factors outlined in the full protocol.

The complete evidence-based regimen — therapy options, selection criteria, and full algorithm — is available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1212/cont.0000000000001598

Spasticity is a motor disorder marked by a velocity-dependent increase in muscle tone or tonic stretch reflexes associated with hypertonia.

Patients with spasticity may benefit from muscle relaxants (such as baclofen and cyclobenzaprine, with potential risks as mentioned earlier), botulinum toxin injection, physical therapy, and occupational therapy.

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