Prise en charge des spasticités douloureuses : pourquoi et comment utiliser les blocs locorégionaux ?

Muscle spasticity causes pain, disability, and difficulties in the rehabilitation of patients with cerebrovascular lesions, head, brain or spine trauma, coma, or neurologic diseases such as multiple sclerosis, amyotrophic lateral sclerosis, or cerebral palsy.Regional blocks have a threefold use in patients with painful spasticity: diagnostic, prognostic, and therapeutic.Blocks are feasible on an outpatient or day-hospital basis.Blocks are applied most often to 4 peripheral sites: the pectoral nerve loop, median, obturator, and tibial nerves.The main indication is debilitating or painful spasticity.Peripheral blocks with local anesthetics are used as tests, to mimic the effects of motor blocks and determine their potential adverse effects, transiently and reversibly.Peripheral neurolytic blocks are easy to perform, effective, and inexpensive.