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Spasticity, defined as a state of increased muscle tone is not a pathology per se but the direct consequence of the evolution of diverse illnesses, such as spinal cord injuries and multiple sclerosis. The therapeutic value of the baclofène as a treatment for spasticity has been proven. This medicine can be administrated both intrathecally and orally. This two-way administration raises questions about the efficacy, the cost and the practical aspects of each method. On the basis of literature review, we can conclude that intrathecal treatment for spasticity has a medical net value advantage and has fewer side effects. Nevertheless, intrathecal administration of baclofène is limited due to a higher cost and more frequent medical complications. Finally, the intrathecal use of baclofène should be adviced for moderate to severe spasticity, whereas the oral treatment should be administered in case of low spasticity. La spasticité qui se définit comme une tendance d'un muscle à être contracté, n'est pas une pathologie en soi mais bien la conséquence directe de l'évolution de diverses pathologies telles que les lésions médullaires et la sclérose en plaques. Au niveau thérapeutique, l'efficacité du baclofene dans le traitement de la spasticité a clairement été démontrée. Celui-ci pouvant être administré soit par voie orale, soit par voie intrathécale ; des questions se posent quant à leur efficacité respective, leur cout ainsi que leurs aspects pratiques. L'analyse de plusieurs études nous permet ainsi de conclure qu'il y a un net avantage à l'utilisation médicale de la voie intrathécale. Les effets secondaires sont moins fréquents. Néanmoins, l'administration du baclofène par voie intrathécale a un cout supérieur et entraine des complications plus fréquentes, qui en limitent son utilisation. Actuellement, l'administration du baclofène par voie intrathécale est préférée pour traiter la spasticité moyenne à sévère, alors que le traitement par voie orale est à privilégier dans le cas de spasticité légère.

Baclofen --- Injections, Spinal --- Muscle Spasticity

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Taking exception from previous publications and reviews, this handbook boldly knits botulinum toxin therapy indications in both dystonia and spasticity. Botulinum toxin therapy has indeed withstood the test of time in terms of its efficacy and safety, as applied in hyperfunctional states of the muscle and exocrine glands. Topics were chosen spanning from the basic science to the clinical applications and to instrument-guidance injections. The format was envisioned to be timely as one (either a novice or an experienced clinician) applies practical approaches with botulinum toxin therapy ranging from straightforward to challenging clinical scenarios. As well, clinicians and students alike will find the book useful in content and relevance to contemporary times. Please read with no fear and don't doubt because indeed you eventually become the winner as you finish the book.

Botulinum toxin --- Dystonia --- Spasticity. --- Therapeutic use. --- Muscle spasticity --- Movement disorders --- Muscles --- Reflexes --- Spasms --- Extrapyramidal disorders --- Diseases --- Medicine --- Neurology --- Mental and Behavioural Disorders and Diseases of the Nervous System --- Health Sciences