Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: LEG SPASMS
Forum: The Neurology and Neurosurgery Forum
Topic Area: Spina Bifida
Posted by CCF neuro MD MM on January 30, 1999 at 13:19:22:
In Reply to: LEG SPASMS posted by MICHAELM on January 29, 1999 at 13:57:49:



I AM A 28 YO MALE WITH SPINA BIFIDA. SINCE BIRTH I HAVE HAD CHRONIC R LEG
SPASMS. THEY START AT THE BOTTOM OF MY RIGHT FOOT AT RADIATE IN TO MY
R BUTTOCKS AND INTO MY GRION REGION. ANY TESTS THAT WERE DONE EXAMPLE(EEG,EMG,MRI)
WERE ALL NEGATIVE. I AM ON NEURONTIN 300 MG 3 TIMES A DAY FOR 2 WEEKS WITH LITTLE HELP.
PT HAS NOT HELP. SOME TIMES I EVEN BECOME INCONTINENT WHEN I GET THE SPASMS
I CAN NOT GET A GOOD NIGHTS SLEEP. ANY INFO WILL HELP


I am not clear as to whether these spasm involve pain, muscle contractions
or both.
Neurontion is very useful in treating pain which origionates from direct
nerve irritation so I presume that this is at least part of the problem.
The dose of neurontin is quite low however and i would not give up on the
drug until a daily dose of 2000 to 3000 mg has been attempted.
If muscle cramps / spasms are the major component of your problem there
are a number of medical strategies available, these are frequently used
in patients who suffer from MS as they often suffer from very disabling
spasticity of the legs.
The drugs used in this case include baclofen which can be taken by mouth
or directly instilled into the space surrounding the spinal cord and
infused continuously via an implanted pump.
I would suggest that you see a neurologist who works with the problem of
spasticity in MS patients in order to have a full evaluation and explore
the options which are available to you.
If you wish to be evauated at the spasticity clinic run by Dr Kinkel in
the Mellen Center for multiple sclerosis at the Cleveland Clinic the
number for appointments is (216 ) 444 5559.


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