Electromyography has been shown to help clarify patient outcomes and may help us to determine the extent of neuronal injury. Somatosensory evoked potentials examine the neuronal circuitry from the feet all the way to the brain. These studies help determine to what degree the neuronal impulses are getting through the damaged area, thereby clarifying the prognosis for continued recovery. As indicated previously, most patients with TM have spasticity, while a fair number of patients have pain due to their illness. Both symptoms interfere with recovery and with quality of life.
Spasticity often makes it harder to ambulate or to utilize the extremities in a coordinated fashion.
A wide variety of medications are available for these problems, but for patients with TM, medications are occasionally prescribed in inadequate doses, or in suboptimal combinations. Some of these medicines have troubling side effects including fatigue. For some patients, a novel approach employed at Johns Hopkins may be appropriate. He can then administer medicines directly into this fluid either for pain control or for relief of spasticity. The medicines do not get distributed throughout the body, and so there are fewer side effects from this approach.