Update on tizanidine for muscle spasticity and emerging indications
Clinical Professor, Physical Medicine and Rehabilitation, Director Overlook Pain Center, Associates in Rehabilitation Medicine, 11 Overlook Road, MAC II, Suite B110, Summit, NJ 07091, USA. Expert Opinion on Pharmacotherapy
(Impact Factor: 3.53).
09/2008; 9(12):2209-15. DOI: 10.1517/146565126.96.36.1999
Tizanidine hydrochloride, an alpha(2)-adrenergic receptor agonist, is a widely used medication for the treatment of muscle spasticity. Clinical studies have supported its use in the management of spasticity caused by multiple sclerosis (MS), acquired brain injury or spinal cord injury. It has also been shown to be clinically effective in the management of pain syndromes, such as: myofascial pain, lower back pain and trigeminal neuralgia. This review summarizes the recent findings on the clinical application of tizanidine.
Our objective was to review and summarize the medical literature regarding the evidence for the usefulness of tizanidine in the management of spasticity and in pain syndromes such as myofascial pain.
We reviewed the current medical and pharmacology literature through various internet literature searches. This information was then synthesized and presented in paragraph and table form.
Tizanidine hydrochloride is a very useful medication in patients suffering from spasticity caused by MS, acquired brain injury or spinal cord injury. It can also be helpful in patients suffering from chronic neck and/or lower back pain who have a myofascial component to their pain. Doses should be started at low dose and gradually titrated to effect.
Available from: Naonobu Takahira
- "Physiological treatment has involved stretch exercises and foot splints worn at night (Man-Son-Hing et al. 1998; Blyton et al. 2012; Hallegraeff et al. 2012). Pharmacological treatments have included quinine, magnesium citrate, vitamin D3, tizanidine hydrochloride, eperisone hydrochloride, vitamin B, vitamin C, vitamin E, taurine, epalrestat, gabapentin, verapamil , carisoprodol, orphenadrine, and Shakuyakukanzo-to (a Chinese herbal medicine) (Fowler 1973; Daniel 1979; Pitkin 1983; Warburton et al. 1987; Sontag and Wanner 1988; Yamamoto 1994; Chan et al. 1998; Abdulla et al. 1999; Serrao et al. 2000; Khajehdehi et al. 2001; Roffe et al. 2002; Hinoshita et al. 2003; Miller and Layzer 2005; Guay 2008; Malanga et al. 2008; Ziegler 2008; El-Tawil et al. 2010; Chandanwale et al. 2011; Chandok et al. 2011; Blyton et al. 2012; Hallegraeff et al. 2012). In Japan, peripheral nerve block has been used as a treatment for nocturnal leg cramps. "
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ABSTRACT: IntroductionPatients with lumbar spine disease sometimes complain of nocturnal leg cramps. We sought to investigate the effectiveness of blocking the medial branch of the deep peroneal nerve as treatment for nocturnal leg cramps after spinal surgery for lumbar spine disease.Methods
We evaluated 66 postoperative patients in this prospective comparative study of a group of patients with a nerve block (n = 41) and a control group without (n = 25). In the block group, the medial branch of the deep peroneal nerve was blocked at the distal two-thirds of the interspace between the first and second metatarsals using 5.0 mL of 1.0% lidocaine.ResultsTwo weeks after the block, the frequency of nocturnal leg cramps was reduced to less than a quarter of pretreatment baseline frequency in 61.0% of patients (n = 25) and less than half in 80.5% (n = 33). In the control group, the frequency of the leg cramps was reduced from baseline in 32.0% of patients (n = 8), and was unchanged or increased in 68.0% (n = 17) at 2 weeks. Cramp frequency was reduced to less than a quarter or less than half of baseline frequency in a significantly (P < 0.05 and P < 0.01, respectively) larger percentage of patients in the block group. The severity of each cramp was less in about two-thirds of patients (63.4%; n = 26) in the block group and was unchanged in one-third (31.7%; n = 13).Conclusions
Blocking the medial branch of the peroneal nerve can be an effective, long-lasting, and simple treatment with low risk for nocturnal cramps sustained after lumbar spine surgery.
Brain and Behavior 08/2015; 5(9). DOI:10.1002/brb3.370 · 2.24 Impact Factor
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ABSTRACT: In this work a coplanar waveguide (CPW)-fed slot dipole antenna has been integrated with a three-dimensional woodpile photonic bandgap crystal (PBG) in the W-band regime (67-110 GHz) using silicon. A slot dipole antenna has been designed and tested at 94 GHz which exhibits very poor efficiency and has high levels of loss through the back of the substrate. This integration has shown a large positional dependence of the antenna with respect to the layers of the PBG and has led to the optimisation of a slot dipole antenna on the PBG. This type of integration has shown experimentally that the overall operation of an antenna can be greatly improved due to the reflective properties of the PBG.
Antennas and Propagation Society International Symposium, 2004. IEEE; 07/2004
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ABSTRACT: The Side Effects of Drugs Annuals form a series of volumes in which the adverse effects of drugs and adverse reactions to them are surveyed. The series supplements the contents of Meyler's Side Effects of Drugs: the International Encyclopedia of Adverse Drug Reactions and Interactions. This review of the 2011 publications on neuromuscular blocking agents and skeletal muscle relaxants covers the depolarizing neuromuscular blocking agent suxamethonium (succinylcholine), the non-depolarizing neuromuscular blocking agent rocuronium, the rocuronium-reversing agent sugammadex, and several skeletal muscle relaxants (baclofen, botulinum toxins, cyclobenzaprine, dantrolene sodium, tetrabenazine, and tizanidine). It includes a special review on the management of rocuronium-induced anaphylaxis with sugammadex.
Side Effects of Drugs Annual 01/2009; 28(1):155-159. DOI:10.1016/S0378-6080(05)80434-9
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