Midodrine: Insidious development of urologic adverse effects in patients with spinal cord injury: A report of 2 cases

2007 ◽  
Vol 24 (4) ◽  
pp. 712-720 ◽  
Author(s):  
Subramanian Vaidyanathan ◽  
Bakul M. Soni ◽  
Peter L. Hughes
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Effects ◽  
Cord Injury ◽  
Insidious Development

Unwanted Muscle Weakness following Botulinum Neurotoxin A Administration in Spinal Cord Injury with Literature Review

2012 ◽  
Vol 23 (1) ◽  
pp. 20-24
Author(s):  
Tapan N Joshi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Effects ◽  
Muscle Weakness ◽  
Botulinum Neurotoxin ◽  
Adult Population ◽  
Functional Decline ◽  
High Dose ◽  
Botulinum Neurotoxin A ◽  
Cord Injury

Abstract Botulinum neurotoxin A (BoNTA) is rapidly gaining acceptance for management of spasticity secondary to spinal cord injury (SCI). Due to its increased usage, more undesirable effects and complications have come in light. Unwanted distant and/or generalised muscle weakness is possible following BoNTA administration in SCI population causing temporary neurological and functional decline. Physicians should carefuly perform a clinical assessment of every patient individually for risks stratification. Additional studies for adult population evaluating adverse-effects of high dose of BoNTA treatment for spasticity management are indicated.

Intrathecal Baclofen for Severe Spasticity Secondary to Spinal Cord Injury

1993 ◽  
Vol 27 (6) ◽  
pp. 767-774 ◽  
Author(s):  
Kelly S. Lewis ◽  
Wade M. Mueller
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Spinal Cord Injury ◽  
Nervous System ◽  
Adverse Effects ◽  
Intrathecal Baclofen ◽  
Clinical Effects ◽  
Spinal Cord Trauma ◽  
Open Label ◽  
Cord Injury

OBJECTIVE: To evaluate the use of intrathecal baclofen for the treatment of muscle spasticity in patients with spinal cord injury. DATA SOURCES: A MEDLINE search was used to identify relevant and pertinent literature. Information was obtained from open-label clinical trials, abstracts, conference proceedings, and review articles. Index terms in the search included baclofen, spasticity, intrathecal drug infusion, spinal cord disease, and neurosurgery. DATA EXTRACTION: Studies were selected for review if they evaluated intrathecal baclofen in patients with spinal cord injury. Emphasis was placed on human studies published in the English language. Trials were reviewed by dosage regimen, therapeutic response, adverse effects, and complications. DATA SYNTHESIS: Thus far, intrathecal baclofen administration shows promise in the treatment of spasticity resulting from spinal cord trauma. Few complications and adverse effects have been reported. CONCLUSIONS: Muscle spasms and spasticity constitute a significant problem in spinal cord injuries, interfering with rehabilitation and leading to inconveniences and complications in these patients. Oral baclofen is the drug of choice for spasticity due to spinal cord trauma. It often is ineffective, however, because of the large dosages required to cross the blood-brain barrier and the subsequent appearance of central nervous system adverse effects. These adverse effects are not tolerated by many patients. Intrathecally administered baclofen has been approved by the Food and Drug Administration (FDA) for the treatment of spasticity in patients with spinal cord injury who are refractory to or cannot tolerate oral baclofen. It is intended for use only in implantable pumps approved by the FDA for the administration of baclofen into the intrathecal space. Intrathecal administration achieves high concentrations in the spinal cord with small dosages, thus reducing the incidence of central nervous system adverse effects. To date, approximately 350 patients with spinal cord injury have been treated with intrathecal baclofen. Reductions in spasticity have been demonstrated in both open-label and placebo-controlled trials. Patients also often make substantial gains in activities of daily living. Few adverse effects and complications have been reported. However, tolerance to the clinical effects of intrathecal baclofen has been reported. Further studies are needed to determine specific patient populations that may benefit most from intrathecal baclofen administration. Individual dosage ranges and follow-up care also need to be defined more completely. In addition, the question of whether tolerance detracts from long-term clinical benefits with intrathecal baclofen needs to be addressed.

scholarly journals Nor-Binaltorphimine Blocks the Adverse Effects of Morphine after Spinal Cord Injury

2017 ◽  
Vol 34 (6) ◽  
pp. 1164-1174 ◽  
Author(s):  
Miriam Aceves ◽  
Eric A. Bancroft ◽  
Alejandro R. Aceves ◽  
Michelle A. Hook
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Effects ◽  
Cord Injury

scholarly journals The Efficacy and Safety of Mesenchymal Stem Cell Transplantation for Spinal Cord Injury Patients: A Meta-Analysis and Systematic Review

2018 ◽  
Vol 28 (1) ◽  
pp. 36-46 ◽  
Author(s):  
Panfeng Xu ◽  
Xianliang Yang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Effects ◽  
Cell Transplantation ◽  
Meta Analysis ◽  
Urine Volume ◽  
Efficacy And Safety ◽  
Motor Score ◽  
Residual Urine Volume ◽  
Cord Injury

Spinal cord injury (SCI) is a devastating disease, with a high rate of disability. In this meta-analysis, we aimed to comprehensively assess the efficacy and safety of mesenchymal stem cells (MSCs) in treating clinical SCI patients. We systematically searched the PUBMED, EMBASE, Chinese Biomedical (CBM), Web of Science and Cochrane databases using the strategy of combination of free-text words and MeSH terms. The indicators of the American Spinal Injury Association (ASIA) impairment scale (AIS)-grading improvement rate and adverse effects were displayed with an overall relative risk (RR). For the continuous variables of the ASIA motor score, light-touch score, pinprick score, activities of daily living (ADL) score, and residual urine volume, we used odds ratio (OR) to analyze the data. Eleven studies comprising 499 patients meeting all inclusion and exclusion criteria were included. No serious heterogeneity or publication bias was observed across each study. The results showed that significant improvements of total AIS grade (RR: 3.70; P < 0.001), AIS grade A (RR: 3.57; P < 0.001), ASIA sensory score (OR: 8.63; P < 0.001) and reduction of residual urine volume (OR: −36.37; P = 0.03) were observed in experimental group compared with control group. However, no significant differences of motor score (OR: 1.37, P = 0.19) and ADL score (OR: 2.61, P = 0.27) were observed between experimental and control groups. In addition, there were no serious and permanent adverse effects after cell transplantation. Cell transplantation with MSCs is effective and safe in improving the sensory and bladder functions of SCI patients.

scholarly journals Potential adverse effects of cyclosporin A on kidneys after spinal cord injury

Spinal Cord ◽  
2010 ◽  
Vol 49 (3) ◽  
pp. 472-479 ◽  
Author(s):  
N Lonjon ◽  
G Boniface ◽  
R Feifel ◽  
R Endres ◽  
M Gimenez y Ribotta ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Effects ◽  
Cyclosporin A ◽  
Cord Injury

Propantheline Bromide in the Management of Hyperhidrosis Associated with Spinal Cord Injury

1995 ◽  
Vol 29 (5) ◽  
pp. 489-492 ◽  
Author(s):  
Bruce R Canaday ◽  
Richard H Stanford
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Effects ◽  
Neurogenic Bladder ◽  
Systemic Therapy ◽  
Case Reports ◽  
Pertinent Literature ◽  
Profuse Sweating ◽  
Cord Injury ◽  
Propantheline Bromide

Objective: To report 2 cases in which oral propantheline reduced the discomfort associated with sweating related to spinal cord injury (SCI), and to review the literature on the management of SCI-related sweating. Case Summaries: Case 1: A 27-year-old quadriplegic man with an American Spinal Injury Association (ASIA) Frankel class C injury to C5/C6 experienced profuse sweating and requested propantheline. He stated that he had received the medication previously and reported that propantheline 15 mg tid had controlled his sweating. Propantheline bromide was reinstituted, and within 24 hours, the patient's episodes of profuse sweating had decreased markedly in number and frequency. Case 2: A 35-year-old quadriplegic woman had an ASIA class D lesion at C3. Since her injury, she had experienced profuse sweating that worsened when she became cold and at night. She stated that her sweating was under control as long as she took propantheline. Propantheline therapy was continued and no further sweating episodes have occurred. Data Source: A MEDLINE search was used to identify pertinent literature including reviews. Standard texts and texts referenced in the pertinent literature also were examined. Study Selection: All available sources of information were reviewed. Data Synthesis: The earliest case reports of systemic therapy for hyperhidrosis described the use of the anticholinergic methantheline bromide. Methantheline in combination with ergoloid mesylates also was suggested for the treatment of congenital hyperhidrosis. Local topical therapy for hyperhidrosis, such as aluminum chlorohydrate and aluminum chloride, the active ingredients in some antiperspirants, have been tried with some success. Talc, starch, and other powders have been suggested to absorb excessive sweat. Formalin and glutaraldehyde also have been used. Topical propantheline bromide has been used successfully in treating palmar and plantar hidrosis. Clonazepam has been used successfully in a case of unilateral localized hyperhidrosis. Systemic phenoxybenzamine has been used with some success and there have been attempts at other systemic therapy using mecamylamine, atropine, propoxyphenel, and methenamine. Scopolamine patches also have been used successfully in a small number of patients. Other agents that have been used include dibenamine, piperoxan, and phentolamine. Systemic propantheline also has been listed as an agent with potential efficacy in treating the profuse sweating associated with SCI, but was not recommended primarily because of adverse effects and difficulty in titrating to the lowest effective dosage. However, studies or case reports specific to the use of propantheline in patients with SCI appear to be lacking, as are reports of direct comparison between propantheline and other agents. Discussion: Concerning the mechanism of action of propantheline bromide for hyperhidrosis, it seems reasonable to attribute its effects to the drug's well-documented anticholinergic/antimuscarinic actions. At dosages used to effectively treat neurogenic bladder, propantheline bromide also should block the muscarinic receptors responsible for sweat gland stimulation. Central nervous system adverse effects should be minimal at usual clinical dosages, as propantheline does not cross the blood–brain barrier. Conclusions: It would appear that in some patients with SCI who are subject to incidental episodes of profuse sweating, oral propantheline may offer some relief and may, in fact, be well tolerated, as in the cases described. Additionally, propantheline would seem a good therapeutic choice in SCI patients with excessive sweating and neurogenic bladder dysfunction who may derive dual benefit from the agent.

Author response for "Identification of regenerative processes in neonatal spinal cord injury in the opossum ( Monodelphis domestica ), a transcriptomic study"

2019 ◽  
Author(s):  
Benjamin J Wheaton ◽  
Johnny Sena ◽  
Anitha Sundararajan ◽  
Pooja Umale ◽  
Faye Schilkey ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Monodelphis Domestica ◽  
Author Response ◽  
Regenerative Processes ◽  
Cord Injury
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