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Stroke help re: Spasms
jmontario posted:
My husband had a stroke 22 and 1/2 yrs. left side paralyzed and is in a wheelchair in long term care. Now he is getting spasms up of 5 to 7 per day. not painful, but he says like a charge going through him. He shakes at that time also. Can anyone tell me if this is common after 2 years later. jmontario
Richard C Senelick, MD responded:
The first step is to determine what type of "spasms" he is having. After a stroke people can develop spasticity (tightness) in their muscles. This can worsen over time and may or may not be painful. We have medications like baclofen and tizanadine that can help control the spasms. Small focal seizures can also look like spasms and would be treated with a medications for seizures. Finally, stroke survivors can feel "electric" or "shock-like" sensations in their paralyzed limbs. This is called neuropathic pain and can be treated with many of the same medications used for seizures, although there are also medications for this type of discomfort.

The challenge may be arranging to get him seen by someone who can determine what type of problem he is having. Does he have a neurologist? Can he be transported to a neurologist's office for a consultation? He may have a very good primary care doctor who visits him at the long term care facility, but that doctor may or may feel comfortable treating this type of problem. Start with the primary care doctor and ask whether he can arrange a neurologic consultation. Finally, many of these medications can affect a person's thinking or make them sleepy, so be on the look out for side effects. Ask them to start with a very low dose.

I hope this helped. Good Luck
After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been. You still can achieve new goals.
jmontario replied to Richard C Senelick, MD's response:
Thank You for your comments. He is also on Riddlen, which may be causing these spasms now. He needs it to keep focused . He has been on Riddlen for 2 an d 1/2 years since his stroke. 1/2 tablet in a.m. other half at lunch. Long term facility doctor just today has reduced the Ridlen to once a day to see how he will cope. Also a neurologist appointment is being made, which seems like a 6 month wait. Is there any other medications that can be used instead of Ridlen to help with focusing ?
Richard C Senelick, MD replied to jmontario's response:
There are other medications that can improve alertness and attention but they are much more expensive than Ritalin. They are all "off label" usage, meaning that it is not what they are approved for. The most common other medication that doctors use is modafanil ( Provigil) but it costs about $15 per pill in the USA. Good Luck
After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been. You still can achieve new goals.

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Richard C. Senelick M.D. is a physician specializing in both neurology and the subspecialty of neurorehabilitation. He did his undergraduate and medic...More

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