While usual baclofen regimens range between 40-80 mg a day in split dosages, some patients may require daily doses as high as 200 mg. Patients should be aware that sudden withdrawal of high daily doses of baclofen can result in delirium, even seizures, and that baclofen requirements can vary daily and should be adjusted continually by a neurologist. There are few alternatives to baclofen. A new drug available in Europe, tizanidine is now under investigation in the U.S. and may be approved for release in 1995. Active stretching programs and yoga can be enormously helpful if done faithfully.
Swimming is particularly effective in improving range of motion and in reducing muscle stiffness.
And occasionally wrapping the involved limbs briefly with ice packs can reduce spasticity for up to 24 hours. Severe spasticity requires more aggressive intervention. Obturator nerve block is a simple, effective technique in which a substance such as phenol or alcohol is injected into the thigh nerve to paralyze the hip muscles. The effects are temporary and limited to the hip muscles. In dorsal rhizotomy, sensory nerves adjacent to the spinal cord are surgically sectioned off to reduce the cord's sensory input and consequently reduce spasticity.