• Outline the various therapeutics that may be employed to alleviate spasticity
• Discuss in detail the use of various oral medications which can alleviate spasticity
• Discuss in detail the use and administration of botulinum toxin to alleviate spasticity
• Discuss in detail the use and administration of intrathecal baclofen to alleviate spasticity

Randall T. Schapiro, MD
Program Chair
Clinical Professor of Neurology
University of Minnesota
Schapiro Center for Multiple Sclerosis
Minneapolis Clinic of Neurology

Randall T. Schapiro, MD, was born and raised in Minnesota. After graduating from Occidental College in Los Angeles, in biology, he graduated from the University of Minnesota Medical School. He trained in internal medicine at the Wadsworth VA Medical Center (UCLA) in Los Angeles and in neurology under A. B. Baker, MD, at the University of Minnesota. Following a short stint as a faculty member and director of the MS clinic at the University of Minnesota, he founded the first comprehensive MS center, The Fairview MS Center, in 1977, which was renamed The Schapiro Center for Multiple Sclerosis at the Minneapolis Clinic of Neurology in 2004. He was the first elected president of the consortium of MS centers, an organization which he helped found. He has participated in the development of the Heuga Center, a wellness center for MS based in Colorado, and was given their Can Do award. He has been elected to the National Multiple Sclerosis Society Hall of Fame and has served on numerous advisory committees for them, including the Medical Advisory Board. He also serves on the International Multiple Sclerosis Society’s Medical Advisory Board. He has served on the National Board of the National Multiple Sclerosis Society for three years, and he is serving his 29th year on the local board of the National Multiple Sclerosis Society. He has lectured and written extensively, nationally and internationally, on all topics associated with MS management. While he has participated in numerous research studies, he is best known for his educating and patient management style, often using humor to teach sensitive topics.

Ted Brown, MD, MPH
Multiple Sclerosis Center at Evergreen
Evergreen Hospital Medical Center
Kirkland, Washington

Ted R. Brown, MD, MPH, attended Harvard Medical School and completed his internship and residency in physical medicine and rehabilitation at the University of Washington. From 1993-2002, he worked at a rehabilitation center in northern Thailand, where most of the rehabilitation cases were leprosy, stroke, or road traffic injury victims. In 2002, Dr Brown obtained a Masters of Public Health at the University California Berkeley and then did a one-year clinical fellowship in MS at the University of Washington under the direction of George Kraft, MD, and James Bowen, MD. Dr Brown practiced at the MS hub in Seattle until this year. Currently, he works at the Multiple Sclerosis Center at Evergreen Hospital Medical Center in Kirkland, Washington. Dr Brown participates in many National Multiple Sclerosis Society patient education events and as the principle investigator of several ongoing studies. His research interests are in fatigue, ambulation, and exercise in MS.

Douglas R. Jeffery, MD
Associate Professor¸ Department of Neurology
Director of the Multiple Sclerosis Clinic
Wake Forest University School of Medicine
Winston-Salem, North Carolina

Douglas Jeffery, MD, PhD, completed his undergraduate studies at the University of Maryland, College Park, Maryland. He earned his PhD in pharmacology and therapeutics from the State University of New York School of Medicine in Buffalo, New York, in 1983. He earned his medical degree from the same institution in 1987. Dr Jeffery completed his internship program at the State University of New York in Buffalo. He completed his residency in neurology at the University of New Mexico.

Dr Jeffery served as a staff physician and instructor for the Department of Neurology and Spinal Cord Injury Unit at the Veterans Administration Medical Center and the University of New Mexico from July 1992 to December 1993. He has been an assistant professor in neurology at the Wake Forest University School of Medicine since January 1994. He was certified in neurorehabilitation through the American Society of Neurorehabilitation in March of 1994 and board certified in neurology in June 1994.

Dr Jeffery's area of clinical and research interest is MS. His current grant support includes Teva Marion's Evaluation of Injected Glatiramer Acetate in Primary Progressive Multiple Sclerosis, Teva Marion's Evaluation of Oral Glatiramer Acetate in Relapsing Remitting Multiple Sclerosis, Pfizer's Evaluation of Donepezil in the Treatment of Cognitive Dysfunction in Multiple Sclerosis, Immunex and Berlex's Evaluation of Mitoxantrone in Treatment of Multiple Sclerosis, and Elan's Evaluation of Zanaflex Modified Release in the Treatment of Spasticity in Multiple Sclerosis and Spinal Cord Injury.

Credit Designation
The Postgraduate Institute for Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Fee Information
There is no fee for this educational activity.

Disclosure of Conflicts of Interest
The Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements of quality in healthcare and not a specific proprietary business interest of a commercial interest.

The following faculty reported a real or apparent conflict of interest:

Randall T. Schapiro, MD (Program Chair) Type of financial relationship: grants/research support for Acorda Therapeutics. Consultant for Acorda Therapeutics, Berlex, Teva, Serono and Pfizer.

Ted Brown, MD, MPH Type of financial relationship: grants/research support for Serono, Forest Laboratories Inc. Consultant for Acorda Therapeutics. Received honorarium from Biogen IDEC, Berlex, Medtronic, and Allergan.

Douglas R. Jeffery, MD No financial interest/relationships relating to the topic of this activity.

The following planners and managers reported a real or apparent conflict of interest:

Thomas Maxwell Mundy, MD (Healthology) No financial interest/relationships relating to the topic of this activity.

Jan Hixon, RN, BSN, MA (PIM) No financial interest/relationships relating to the topic of this activity.

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed post-test with a score of 70 percent or better. Your statement of credit will be mailed to you within three weeks.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, Healthology Inc., and Biogen IDEC and Elan Pharmaceuticals Inc. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Botox and Gabapentin will be referenced and are unlabeled/unapproved.

Produced by Healthology Inc. © 2006

Sponsored by the Postgraduate Institute for Medicine
Supported through an educational grant from Biogen IDEC and Elan Pharmaceuticals Inc.