1b) I am Miguel Escalon, MD, MPH @dr_escalon: Vice Chair, Director of #ICURehab & #PMR Residency Program Director at @MountSinaiRehab and I will be your guide. @acpepharmacy @accme @ANCCofficial #FOAMed #neurotwitter @MedTweetorials pic.twitter.com/i6boYqsL5k
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
3a) #Spasticity is a velocity dependent, abnl ⬆️ in muscle tone that presents as spasm or stiffness. It is an upper motor neuron symptom & it can limit a person’s ability to complete functional movements or tasks or for caregivers to position a person for care or safe transfer. pic.twitter.com/7u4vvWmIOt
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
4) In a recent study of over 2000 people with #MS, roughly what percentage of persons noted that #spasticity was a symptom of #MS that was negatively affecting their quality of life?
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
6) #Spasticity can lead to decreased function like trouble walking or getting dressed. It can cause intractable #pain, and it can increase #caregiver burden during transfers or even activities of daily living #ADL.
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
8a) In 🇺🇸 common 💊 for spasticity include baclofen, tizanidine, benzodiazepines, & dantrolene. Each med has the potential to cause side effects that can impact day to day life or have serious medical consequences.
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
9a) In 🇺🇸 common 💉 for tx of #spasticity include botulinum toxins for #chemodenervation and phenol (or other alcohols) for #chemoneurolysis. Toxin injections can work well for focal spasticity and have relatively little side effects.
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
10) Which of the following is not an acceptable form of guidance to perform chemodenervation for the treatment of #spasticity?
a. Manual palpation of muscles
b. Electromyography
c. Electrical Stimulation
d. Ultrasound— MultipleSclerosis_CME (@ms_cme) October 19, 2022
12) #Cryoneurotomy, a minimally invasive technique, has been described in the literature for treatment of #spasticity and has shown promising results @drpaulwinston @shenglimdphd
See @AJPMRjournal 🔓 https://t.co/LBoCqSiywk pic.twitter.com/iJatzpNdGd— MultipleSclerosis_CME (@ms_cme) October 19, 2022
14) A patient with an #intrathecal #baclofen pump must be monitored closely since withdrawal from this tx can be severe and even deadly. Patients should be educated of the importance of keeping refill appointments prior to implantation.
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
16) ⁉️ Did you know that there are treatments for #spasticity in other countries that are not available in 🇺🇸? #Cannabanoids are an example with extensive literature/research available. A terrific review in @fsgnmt is here: 🔓 https://t.co/uebhnk4CZ1 pic.twitter.com/MLNTEiSXbp
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
18) There are several routes of administration for #Cannabanoids including inhalation, oral, oromucosal, sublingual, transdermal, eye drops, topical, and rectal. Clinically, inhalation, oromucosal and oral are most common. See https://t.co/iKpVoV8sBQ
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
20) The @mssocietyuk reported that symptoms in #MS most relieved by #Cannabinoids were #spasticity, stress, mood, sleep and pain. See 🔓 https://t.co/4p5l0SHnyh
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
22) European prospective studies using #cannabinoids have shown a 3-month 30% responder rates of between 30 to 40% relief of #spasticity symptoms in persons with #MS.
See
👉https://t.co/tEuM0KqMTS
👉https://t.co/sGBaR81ibb 👉🔓https://t.co/lrhKaD9Bsz— MultipleSclerosis_CME (@ms_cme) October 19, 2022
24) Cannabinoids have been utilized in MS for many years. A review of 10 years of clinical practice using #cannabinoids to treat #spasticity in #MS has shown no new safety signals. See 🔓 https://t.co/uebhnk4CZ1
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
26) #spasticity is an insufficiently treated symptom of #MS that can severely impact #QoL in persons with MS
— MultipleSclerosis_CME (@ms_cme) October 19, 2022
28) And that's it–you just earned 0.5hr CE/#CME! Go to https://t.co/yoactprEhM and claim your certificate. I am @dr_escalon and Program Chair @SKriegerMD thank you for joining us.
Tip o' the 🎩to @shenglimdphd @drpaulwinston @mvgutierrezmd @cbivanhoe @mdketchum @craigditommaso— MultipleSclerosis_CME (@ms_cme) October 19, 2022
