Neuroprotection (Acute Phase)

Nimodipine

Nimodipine is a calcium channel blocker initially developed to treat high BP. Its mechanism of action in treating acute SCI is thought to include lowering of BP and slowing the flow of calcium into blood vessels to reduce injury related ischemia (Fehlings & Baptiste 2005). Nimodipine has only been investigated in one clinical trial for acute SCI in humans to date.

Table 5. Nimodipine for Neuroprotection in Acute SCI

Discussion

Pointillart et al. (2000) did not find any significant differences in terms of neurological recovery among individuals receiving MP, nimodipine, MP plus nimodipine, or no treatment.Animal studies have shown that nimodipine on its own may not be beneficial for treating SCI (Faden et al. 1984a; Ford & Malm 1985), but when used in combination with other agents, such as adrenaline, there were significant effects on enhancing spinal cord blood flow (Ross & Tator 1991). Larger, randomized clinical trials are necessary to determine the effectiveness of nimodipine on neurological recovery in acute SCI.

Conclusion

There is level 1b evidence (from one RCT: Pointillart et al. 2000) that nimodipine is not effective in promoting neurological recovery in acute SCI individuals.

Nimodipine is not effective for neurological recovery during the acute phase post SCI.

Chapter Downloads

Neuroprotection Module With Tables

Patient Handouts

SCIRE Community: Neuroprotection

Toolkits and CPGs

Active Clinical Trials