Neurosurgical Spasticity Treatment: From Lesion to Neuromodulation Procedures

Spasticity is one of the most important and residual signs after pyramidal and para-pyramidal catastrophic lesions after diverse neurological insults, including stroke, brain and spine trauma and post-radiation; infection and immunological diseases affecting nervous system, between others. Spasticity is normally a compensatory motor mechanism that could ameliorate the patients´ disability. Nevertheless, disastrous spasticity is described when the extremities force is diminished in the affected limbs, or when is impossible to wake o to take objects, maximum when hand or foot deformity is exposed. The objective of this chapter is centered in the neurosurgical treatment of spasticity, including brain lesions with specific targets and the spine with its different modalities. This review shows not only the basic aspects in these techniques, but also the option of infusion pumps and deep brain stimulation. To close, a proposal is stablished to determinate the possible path to treat the spasticity in the future.