05/22/2013 // Concord, CA, USA // LifeCare123 // Greg Vigna, MD, JD, Joe Motta, JD // (press release)
Medical Perspective:
Traumatic brain injured, stoke survivors, and spinal cord injured develop what is termed upper motor neuron problems related to increase in tone and the development of spasticity. Tone is the resistance to passive stretch that is encountered when someone attempts to move a joint and spasticity is a velocity dependent increase in tone. Spasticity causes disability by interfering with normal movement by causing increase in stiffness the faster a person tries to move. In patients with severe spasticity and severe neurologic deficits spasticity interferes with functional mobility and may cause contractures. Botox is a proven medical intervention that is safe but its use is unfortunately underutilized because of economic pressures on the health care system.
Frequently encountered in the severe traumatic brain injured population is upper extremity focal or isolated spasticity such as the clenched fist and flexion at the wrist that causes both pain and prevents hand and finger hygiene. These unfortunate patients will often develop sores from their fingernails digging into their palms and painful contractures. Patients with less severe spasticity may have impaired function because the finger and wrist flexors spasticity interferes with wrist extension and hand opening that is required for functional use of the hand.
Botox is a proven intervention that is safe, well tolerated, and proven to improve both function and quality of life of patients with focal upper extremity spasticity. Botox into the biceps may improve functional elbow extension allowing a patient to reach more effectively. Botox into the finger flexors and the wrist flexors may decrease contractures, improve passive mobility to allow improved hygiene, and in the carefully selected patients may improve grip.
Life Care Planner Perspective:
All necessary and appropriate care that improves a traumatic brain injured health and psychosocial welfare should be included in a patient’s life care plan. Botox is a proven intervention that may decrease the frequency of contractors that cause pain, interfere with hygiene, and in some cases interfere with function. The life care plan will include the amount, frequency, and the duration of use of Botox.
Lawyer Perspective:
An attorney must understand all cost related to the management of spasticity in a traumatic brain injured client. These cost include past and future economic (medical costs) and noneconomic (pain and suffering) damages to the life expectancy of a client. An underfunded settlement would preclude treatment for spasticity leading to functional impairment and other complications.
Media Information:
Address: 1401 Willow Pass Road, Concord, CA 94520
Phone: 888.990.9410
Url: Lifecare Solutions Group
