[Spinal cord stimulation for post-apoplectic spastic hemiplegia].

Although the therapeutic effect of spinal cord stimulation (SCS) for spastic movement disorders is still controversial, its effect for multiple sclerosis has been supported by several authors. Among various clinical beneficial effects, reduction of the spasticity may be attractive for physical therapy of post-apoplectic patients. Two patients suffered from post-apoplectic spastic hemiplegia were selected for SCS. Electrodes of Medtronic's SCS system were placed at lower cervical or upper thoracic spinal cord extradura. Stimulation of 30-75 Hz in frequency and 0.3-0.5 in voltage continued for 12-14 hours during daytime every days. U.S., a 74-year-old man, suffered from cerebral infarction in the right internal capsule was treated by SCS at one year after the stroke . At the fourth day after SCS spasticity of the lower extremity reduced and his gait improved remarkably. Upper extremity also showed reduction of spasticity at the seventh day after SCS. H/M ratio before SCS was 0.85 and reduced to 0.77 at 68 th day after SCS. Recovery curve of H-wave also improved after SCS. Y.K., a 47-year-old man, suffered from pontine hemorrhage showed right spastic hemiplegia. He was treated by SCS at 13th month after the hemorrhage. Spasticity of the upper extremity reduced slightly and his gait improved obviously. H/M ratio which was 1.05 before SCS, reduced to 0.75 at 122 nd day after SCS. Recovery curve of H-wave improved remarkably after the treatment. It was obvious that the spasticity reduced after SCS and function of the extremities recovered to some extent in above patients.(ABSTRACT TRUNCATED AT 250 WORDS)