Clonidine transdermal system for treatment of spasticity in spinal cord injury.

Clonidine tablets have been used in the past for treatment of spasticity with some success. The use of clonidine, however, has been limited by adverse effects, mainly hypotension. Over a two-year period, 17 patients were started on clonidine transdermal delivery system. They were followed for up to 18 months. Twelve of the 17 patients had a beneficial response and have continued on the patch. In ten of these 12 patients, other antispasticity drugs were either reduced or discontinued. In another three of the 17 patients, the response was good, but the patch was discontinued. No patient demonstrated persistent problematic hypotension. Clonidine Transdermal Patch appears to be an effective treatment for spasticity after a spinal cord injury. Adverse effects appear to be minimized using this mode of delivery.

A new approach to catastrophic injury: spinal cord injury patients.

Catastrophic injuries and illnesses create great financial strains on patients who require lifetime care. Families, health care providers and insurers recognise that individual patient care needs require a closer look at the prudent allocation of health care benefit dollars. Blue Cross Blue Shield of Michigan has initiated an approach to this problem called 'case management'. Two ventilator dependent quadriplegics were discharged home utilising the case management concept. This system provides many advantages for patients. However, the health care team needs to be aware of the drawbacks of the system.

Posterior central cord syndrome following a hyperextension injury: case report.

Throughout the spinal cord literature, a posterior central cord syndrome has been noted to be a rare occurrence. Furthermore, it has never been correlated with a specific type of injury. A patient with clinical signs consistent with a posterior central cord syndrome is discussed, and hyperextension is suggested as a possible mechanism for this type of injury.