WSC 2022 | Progress in post-stroke spasticity

Abhijit Das, MBBS, MD, DM, MRCP, The Walton Centre NHS Foundation Trust, Liverpool, UK, discusses recent developments in the identification and management of post-stroke spasticity. Spasticity is a common complication after stroke (30% to 80% estimated prevalence) and is often associated with pain, loss of range of movement, and joint contracture. Spasticity can have a significant impact on wellbeing. However, much remains unknown about the natural history and the underlying mechanisms at play and thus, progress has been slow. The introduction of botulinum toxin was one of the major breakthroughs in post-stroke spasticity. Various formulations are recommended as the first line treatment for regional spasticity affecting the upper and lower limbs. Additionally, growing evidence supports early intervention, with experts suggesting that botulinum toxin should be administered as soon as spasticity interferes with the patient’s clinical condition. Questions remain regarding optimal timing, adjunctive therapies, and required follow-ups. Dr Das also highlights progress in the early prediction of post-stroke spasticity risk, with several clinical and imaging features identified as showing positive predictive value. This interview took place at the World Stroke Congress 2022 in Singapore.

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