TABLE 2.

Approach to spasticity

Thought-provoking questions	Elements to consider
Is this spasticity?	Completing a detailed history and physical examination is essential to: ○ Differentiate spasticity from rigidity and dystonia, which require different treatments ○ Differentiate between baseline increased muscle tone (spasticity) and intermittent muscle spasms
What are the provoking factors?	Spasticity and muscle spasms can worsen in response to pain, fever, infection and other causes of discomfort Psychological stress and agitation/irritability can increase spasticity
Are medications contributing?	A medication review is always advisable, although this may be less fruitful in spasticity