Intrathecal Baclofen Used Successfully
in Ambulatory Patients With Spasticity
(Note:The term intrathecal means that the
medication is injected directly into the spinal fluid with
the help of a pump and a tube installed through a spinal
tap. It is not used very much in children but could be
efficient in adults forthe treatment of
spasticity.
PHILADELPHIA (Reuters Health) May 09 -
Continuous intrathecal baclofen can be used in ambulatory
patients with spasticity without causing weakness or
interference with other aspects of ambulation, investigators
reported here at a poster session at this week's annual
meeting of the American Academy of Neurology.
Drs. Andrew Sylvester and Saud A. Sadiq,
of St. Luke's-Roosevelt Hospital in New York, screened 23
patients for intrathecal therapy using bolus doses of 75
µg baclofen. Even though many of the patients
experienced weakness during the procedure, based on relief
of their spasticity, the surgeons decided to implant pumps
for continuous infusion.
The initial baclofen dose was 25 µg
daily, with dose adjustment over the next several weeks up
to a maximum of 1200 µg.
"The screening test is where many people
are put off," Dr. Sadiq told Reuters Health. "During
screening, we give baclofen as a bolus dose, which means it
goes through the system like a tidal wave. Patients lose
their ambulation, so they think they are not good
candidates. What we've shown here is that is not the case."
Dr. Sadiq added that patients who "have
good strength" will do well with continuous intrathecal
infusion, as shown by up to 10 years' follow-up of this
cohort.
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