Dosage of intrathecal baclofen maintenance therapy in the spastic syndromes.
Twenty-three patients affected with severe spasticity as a result of several clinical pathologies were treated with intrathecal Baclofen and administered at a lumbar level by means of an implantable infusion system. The system allows programming of any drug dosage in a continuous infusion fashion in the subarachnoid space. The appropriate patients were selected using specific criteria and the patients were regularly reviewed regarding the level of the spasticity and functional capacity. The required daily doses were determined using a specific detailed system. The doses needed varied according to the pathologic or clinical diagnosis. The doses administered by the global method at the beginning of the treatment were 91.96 microg/day and 137.81 microg/day in the final phase. These doses were higher in patients with medullary traumatic lesion, diffuse cerebral lesion and spastic idiopathic paraparesis. Relatively mild side effects were produced by the therapeutic doses used.
Fares
Youssef
Y
Neurosurgical Service, Ntra Sra Clinic of the Conception (Jimenez Diaz Foundation), Madrid, Spain. Faresdr@hotmail.com
Khazim
Rabi M
RM
del Barrio
E R
ER
Burzaco
J A
JA
D000328:Adult; D001418:Baclofen / Q000008:administration & dosage* / Q000009:adverse effects; D002547:Cerebral Palsy / Q000188:drug therapy*; D002574:Cervical Vertebrae; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy*; D009125:Muscle Relaxants, Central / Q000008:administration & dosage* / Q000009:adverse effects; D009128:Muscle Spasticity / Q000188:drug therapy; D010045:Outpatients; D010264:Paraplegia / Q000188:drug therapy*; D018579:Patient Selection; D013118:Spinal Cord Diseases / Q000188:drug therapy*; D013346:Subarachnoid Space; D013997:Time Factors
D009125:Muscle Relaxants, Central; D001418:Baclofen