title: Long-term intrathecal baclofen treatment in supraspinal spasticity.
abstract: Baclofen, a derivate of gamma-amino butyric acid (GABA), is known to be a useful drug in spasticity treatment. To achieve a good therapeutic response higher oral dosages have to be administered related with central side effects. Intrathecal application of Baclofen in microgram range dosages is proved to be effective in spinal spasticity. The efficiency of intrathecal Baclofen in patients suffering from supraspinal spasticity is discussed controversially. We report on 9 patients with long-term intrathecal Baclofen treatment, all of them responding well presenting a marked reduced muscle tone. In most cases an improvement of motor performance and in two cases improved bladder function was observed. The therapeutical dosages administered to patients with supraspinal spasticity exceed those administered to patients with spinal spasticity by approximately 100% without provoking central side effects. Despite the risks connected with this method it has to be considered as treatment of choice in cases of severe supraspinal spasticity.
authors.affiliation: Department of Neurology, University Hospital, Innsbruck, Austria.
authors.forename: L
authors.initials: L
authors.lastname: Saltuari
authors.forename: M
authors.initials: M
authors.lastname: Kronenberg
authors.forename: M J
authors.initials: MJ
authors.lastname: Marosi
authors.forename: M
authors.initials: M
authors.lastname: Kofler
authors.forename: L
authors.initials: L
authors.lastname: Russegger
authors.forename: C
authors.initials: C
authors.lastname: Rifici
authors.forename: P
authors.initials: P
authors.lastname: Bramanti
authors.forename: F
authors.initials: F
authors.lastname: Gerstenbrand
mesh_terms: D000328:Adult; D001418:Baclofen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001930:Brain Injuries / Q000150:complications*; D002547:Cerebral Palsy / Q000150:complications; D006801:Humans; D007260:Infusion Pumps / Q000009:adverse effects; D007278:Injections, Spinal; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D012021:Reflex, Abnormal / Q000187:drug effects; D012640:Seizures / Q000139:chemically induced; D015419:Spastic Paraplegia, Hereditary / Q000150:complications; D014554:Urination / Q000187:drug effects
chemical_list: D001418:Baclofen