Clinical Experience with Spinal Morphine, Midazolam and Tizanidine in Spasticity

The starting point for systemic pharmacological treatment of spasticity was mephenesin, introduced in 1946. Although often stated to depress reflex activity by blocking spinal interneurons without affecting muscular function, mephenesin had a paralyzing effect in experimental animals and in man [2]. It was more or less by chance that mephenesin was also the first non-neurolytic drug to be administered intrathecally in patients with spasticity. According to these investigations intrathecal mephenesin was considered to be a potential alternative to intrathecal phenol or alcohol [10].