Dantrolene sodium in chronic spasticity of varying etiology. A double-blind study

Seventeen patients, 13 males and 4 females, with moderate to severe spasticity caused by varying neurological disorders attended a double-blind, placebo-controlled trial to determine the efficacy and safety of dantrolene sodium. Three patients discontinued, two because of side effects and one because of a laboratory abnormality. In the fourteen subjects who completed the trial there was a statistically significant decrease in resistance to passive stretch, clonus and hyperreflexia without significant reduction of muscle strength. A positive clinical effect was observed in ten patients while a very slight or no effect was seen in four cases. All patients reported adverse reactions during the dantrolene period, six patients during the placebo treatment. Six patients wanted to go on with dantrolene after the trial. On many occasions the urine of the patients turned bright yellow with high doses of dantrolene. It is concluded that dantrolene sodium is an effective antispastic drug in about one-third of patients who suffer from spasticity of varying etiology.

Dorsal longitudinal myelotomy

An evaluation of dorsal longitudinal myelotomy in the management of spasticity of the lower limbs has been done in 17 patients. The follow-up has varied from 1 month to over 2 years. Most patients achieved satisfactory relief from spasticity. Eight patients have died after the operation in chronic care hospitals. In all except one, the spasticity had been relieved. Eight out of the nine living patients have benefited from myelotomy. Recurrence of spasticity following the first operation occurred in four patients, two of whom improved after a repeat myelotomy. In the presence of fixed contractures of the hip and knee joints, a satisfactory clinical result may not be obtained after the myelotomy.