Electrophysiological comparison study between effectiveness of the treatment modalities (Baclofen and Tizanidine drug) on spasticity management

Background: Baclofen and tizanidine are both used for the treatment of muscle spasticity of spinal origin. patients and methods: This study was conducted in Ibn Al-Quf hospital for spinal cord injuries from the period December 2011 to June 2012. All of the participants gave written consent to participate in the study. The patients were divided into 2 groups: Group (I): Baclofen with physiotherapy treatment group; and Group (II): Tizanidine with physiotherapy treatment groups .H-reflex measurements were performed. parameters were studied: H-reflex latency, M wave latency, H-reflex conduction velocity, H-reflex duration, H-reflex amplitude. Results: All the patients had symptoms of spasticity at any time during the day with a Modified Ashworth Scale (MAS) before performing the H-reflex study. highly significant improvement in the H/M ratio when comparing positive controls to the two groups while the H/M ratio in the negative controls shows no significant difference with group I and group II. A significant correlation was noticed between the height of control subjects & H-reflex latency (P= 0.002), significant positive correlation was also found (P=0.028) between the height & M wave latency in the control subjects, The results revealed that the type of treatment did not affect the H-reflex and F wave parameters except for the H/M ratio. conclusion: H-reflex can provide information regarding neural function after spinal cord injury and the H/M ratio can be used as a good indicator for both spasticity assessment and response to treatment. Tizanidine hydrochloride is useful in the management of spasticity caused by SCI and can be used as a routine drug treatment although liver function tests should be periodically monitored.