Focal Spasticity of Upper and Lower Limbs

Abstract Focal spasticity is a common problem after stroke and traumatic brain injury. The surgical treatment of focal spasticity can be designed to address the joints most involved with the spasticity. Given its focal nature, peripheral treatment is the preferred option. The peripheral surgical treatment of choice is peripheral neurotomy. The chosen nerves for treatment are the nerves supplying the largest muscle group contributing to the form of spasticity encountered. Selective neurotomy refers to the technique by which the motor branches of the main nerve are partially severed based on the severity of motor response to stimulation. This technique can be combined with other interventions, such as botulinum toxin injections or tendon lengthening.