Intrathecal Baclofen Therapy for the Treatment of Spasticity in Lithuania

Abstract

Spasticity of cerebral or spinal origin severely impairs an individual's functional ability and quality of life. Intrathecal baclofen (ITB) therapy via an implantable pump is indicated for use in patients unresponsive to oral antispasmodics. ITB therapy improves the daily caring for and relief of painful spasms. In Lithuania, ITB therapy was introduced in clinical practice just recently. We share our experience of spasticity management with the ITB pump system in five patients at Vilnius University Hospital Santariskiu Klinikos. Four patients had spastic tetraplegia associated with cerebral palsy, and one patient developed spastic paraplegia after a spinal epidural abscess.

Keywords

intrathecal baclofen therapy - spasticity - cerebral palsy

• References

• 1 Dario A, Tomei G. A benefit-risk assessment of baclofen in severe spinal spasticity. Drug Saf 2004; 27 (11) 799-818
• 2 Ceulemans B, van Rhijn J, Kenis S, Krols R, Laridon A, Van Havenbergh T. Opisthotonus and intrathecal treatment with baclofen (ITB) in children. Eur J Pediatr 2008; 167 (6) 641-645
• 3 Brennan PM, Whittle IR. Intrathecal baclofen therapy for neurological disorders: a sound knowledge base but many challenges remain. Br J Neurosurg 2008; 22 (4) 508-519
• 4 Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth 2003; 91 (5) 718-729
• 5 Borowski A, Littleton AG, Borkhuu B , et al. Complications of intrathecal baclofen pump therapy in pediatric patients. J Pediatr Orthop 2010; 30 (1) 76-81
• 6 Porter B. A review of intrathecal baclofen in the management of spasticity. Br J Nurs 1997; 6 (5) 253-260, 262
• 7 Albright AL, Shultz BL. Plasma baclofen levels in children receiving continuous intrathecal baclofen infusion. J Child Neurol 1999; 14 (6) 408-409
• 8 Müller H, Zierski J, Dralle D , et al. Pharmacokinetics of intrathecal baclofen. In: Müller H, Zierski J, Penn RD, , eds. Local-spinal Therapy of Spasticity. New York, NY: Springer; 1988: 223-226
• 9 Sadiq SA, Wang GC. Long-term intrathecal baclofen therapy in ambulatory patients with spasticity. J Neurol 2006; 253 (5) 563-569
• 10 Albright AL, Barry MJ, Shafton DH, Ferson SS. Intrathecal baclofen for generalized dystonia. Dev Med Child Neurol 2001; 43 (10) 652-657
• 11 Kroin JS, Ali A, York M, Penn RD. The distribution of medication along the spinal canal after chronic intrathecal administration. Neurosurgery 1993; 33 (2) 226-230 ; discussion 230
• 12 Godwin DA, Kim NH, Zuniga R. Stability of a baclofen and clonidine hydrochloride admixture for intrathecal administration. Hosp Pharm 2001; 36: 950-954
• 13 Mohammed I, Hussain A. Intrathecal baclofen withdrawal syndrome- a life-threatening complication of baclofen pump: a case report. BMC Clin Pharmacol 2004; 4: 6
• 14 Reeves RK, Stolp-Smith KA, Christopherson MW. Hyperthermia, rhabdomyolysis, and disseminated intravascular coagulation associated with baclofen pump catheter failure. Arch Phys Med Rehabil 1998; 79 (3) 353-356
• 15 Mertens P, Parise M, Garcia-Larrea L, Benneton C, Millet MF, Sindou M. Long-term clinical, electrophysiological and urodynamic effects of chronic intrathecal baclofen infusion for treatment of spinal spasticity. Acta Neurochir Suppl (Wien) 1995; 64: 17-25
• 16 Steers WD, Meythaler JM, Haworth C, Herrell D, Park TS. Effects of acute bolus and chronic continuous intrathecal baclofen on genitourinary dysfunction due to spinal cord pathology. J Urol 1992; 148 (6) 1849-1855