Intrathecal clonidine for refractory detrusor hyperreflexia in spinal cord injured patients: a preliminary report.
OBJECTIVE
We assessed the urodynamic effect of various doses of intrathecal clonidine on refractory detrusor hyperreflexia in spinal cord injured patients.


METHODS
Doses of 15, 30 or 45 microg. intrathecal clonidine or placebo were given to 5 chronic complete spinal cord injured patients with detrusor hyperreflexia. Two cystometries were performed before and 5, 30, 60, 90, 120 and 180 minutes after each injection.


RESULTS
A statistically significant dose dependent decrease in detrusor hyperreflexia was observed in each patient without significant side effect.


CONCLUSIONS
Intrathecal clonidine may represent a conservative reversible treatment for detrusor hyperreflexia via a subcutaneous programmable pump, like that used for baclofen, for spasticity. The long-term efficacy needs to be evaluated.
Denys
P
P
Department of Neurological Rehabilitation, Raymond Poincaré Hospital, Garches, France.
Chartier-Kastler
E
E
Azouvi
P
P
Remy-Neris
O
O
Bussel
B
B
D000316:Adrenergic alpha-Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D003000:Clonidine / Q000494:pharmacology / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D012021:Reflex, Abnormal / Q000187:drug effects*; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D001745:Urinary Bladder Diseases / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D014563:Urodynamics / Q000187:drug effects*
D000316:Adrenergic alpha-Agonists; D003000:Clonidine