What about spasms after brain injury?

  First step: 1. Prevention of injurious stimuli: Constipation, urinary tract infection, bladder distention, anxiety, temperature drop, and various other factors may trigger/exacerbate spasms. Patients should learn to observe themselves, analyze the causes, and try to avoid situations that may trigger/exacerbate spasms.  2. Health education: While avoiding triggering/aggravating spasms, learn techniques to suppress/control spasms in daily life, and learn to use spasms to perform daily life actions such as transferring.  Second step: master and adhere to correct body position placement, passive joint movements and stretching techniques.  Third ladder: 1. Therapeutic active movement training; 2. Physiotherapy, hydrotherapy, massage, acupuncture, etc.; 3. Use of orthopedic devices.  Fourth ladder: 1, the use of oral antispasticity drugs represented by Baclofen; 2, neurochemical blockade therapy represented by BTX-A.  Fifth step: 1.Intrathecal drug injection; 2.Surgical treatment such as selective dorsal rhizotomy.  Sixth ladder: 1, orthopedic surgery such as tendon lengthening and tendonotomy; 2, peripheral nerve resection surgery.  Seventh ladder: more destructive surgeries such as myelotomy and anterior lateral spinal column dissection.  The basic principle of the ladder treatment plan is to try not to use the next step of the ladder if the spasticity can be controlled using the previous step method.  The director of our department, Zhao, treats patients with spasticity with cold packs of ice with good results. Our usual acupuncture points on the antagonist muscle also have some effect. However, in a small number of patients, acupuncture was also not effective, and there was even an aggravation of spasticity, so much so that some family members thought that the acupuncture had aggravated the spasticity. Later, by observing and examining these patients, I found that any patient whose spasticity was aggravated was basically accompanied by the presence of other injurious stimuli.