| ||
| | |
|
Dr. Simon Fishman
Combining The Skills Of:
What is spasticity? Spasticity is defined as an involuntary, velocitydependent, increased resistance to stretch. This definition means that the amount of resistance to stretching is partly determined by the speed with which a spastic muscle is stretched, and manifests as pain, tightness, or posturing What is a contracture? Fixed resistance to passive stretching of a joint due to shortening or wasting (atrophy) of muscle fibers, tendons, or the development of scar tissue (fibrosis) of the joints. Causes of Spasticity
Our Approach Spasticity and contractures are symptoms commonly experienced in many different diseases that can affect the nervous system. Therefore, the treatments have to be tailored specifically for each individual patient depending on their underlying ailment, their level of independence, their individual goals, and care setting. The initial assessment and treatment is dependent on the severity of the spasticity, which limbs are affected, the amount of tendon shortening, and any joint abnormalities. Generalized therapy includes treatment with oral medications, or with implantable devices that deliver medicine directly into the spinal canal. Isolated therapy includes injections, particularly with botulism toxin and tendon stretching. Occasionally, patients with severe spasticity or contractures will have difficulty making further progress with no operative treatments. For these patients surgery can be very helpful. Surgery can be a very powerful tool to "unlock" the functional potential within a patient that is being overpowered by spasticity or contractures. This program applies a team approach to treating spasticity and contractures. The combination of dedicated physical/occupational therapists, neurologists, orthopedic/neurological surgeons, and orthotic specialists, all with different but complimentary skills and experiences, ensures the best possible outcome. Dr. Simon Fishman is board certified by the American Board Of Neurology and Psychiatry and the American Board of Neuromuscular and Electrodiagnostic Medicine. He has extensive experience with movement disorders, neuromuscular disease, rehabilitative neurology, stroke, degenerative neurological disorders, and therapeutic use of Botox and Baclofen. Dr. Fishman has been practicing general neurology, since July 2000, in Northern Virginia with admitting privileges at Inova Fairfax and Alexandria Hospitals and Mount Vernon Hospital Scott Edwards, M.D., has been an orthopedist specializing in conditions of the hand, wrist and elbow. He is an active member of the American Academy of Orthopedic Surgeons, American Medical Association, American Society for Surgery of the Hand, and the Washington DC Society for Surgery of the Hand. Locally, he serves as Chief of Hand, Wrist and Elbow Surgery at Georgetown University Hospital, Chief of Hand Surgery at the Inova Fairfax Hospital, and Chief of Orthopedics at the Inova Healthplex Surgery center. |
 | |||
Integrated Neurology Services
| |||
|
| |||
|
The most common causes of
spasticity are lack of oxygen
to the brain before, during,
or after birth (cerebral
palsy); physical trauma (brain
or spinal cord injury);
blockage of or bleeding from
a blood vessel in the brain
(stroke); and multiple
sclerosis (MS). When the
damage that causes the
eventual spasticity first
occurs, the muscles are usually
flaccid before they become
spastic. Spasticity may
not be present all the time—it may be related to a trigger,
or stimulus, such as pain,
pressure sores, a urinary
tract infection, ingrown
toenails, tight clothing, or
constipation.
