Efficacy of early use of intrathecal baclofen therapy for treating spastic hypertonia due to acquired brain injury.
OBJECTIVE
To determine the efficacy and safety of early (<1 year post-disease onset) use of intrathecal baclofen (ITB).


METHODS
Consecutive case series of 14 individuals with spastic hypertonia due to trauma (5), anoxia (6) and stroke (3).


METHODS
Modified Ashworth (MAS) and Disability Rating (DRS) scales.


METHODS
ITB pump placement within 1 year of onset, after inadequate response to other previous treatment modalities.


RESULTS
At follow-up after ITB pump implantation (mean = 13.9 months; mean daily dose = 591.5 microg per day), mean MAS scores improved from baseline by 1.0 and 2.1 points in the upper and lower limbs, respectively. DRS scores did not change significantly. Functional gains included decreased pain and improved gait speed and motor skills. The only complication was spinal leak in one subject.


CONCLUSIONS
ITB therapy within 1 year of onset of acquired brain injury appears effective and safe in decreasing spastic hypertonia and does not appear to adversely affect recovery.
Francisco
G E
GE
Physical Medicine and Rehabilitation Alliance, Baylor College of Medicine and University of Texas Health Sciences Center, Houston, TX, USA. gerard.e.francisco@uth.tmc.edu
Hu
M M
MM
Boake
C
C
Ivanhoe
C B
CB
D000293:Adolescent; D000328:Adult; D000368:Aged; D001418:Baclofen / Q000008:administration & dosage*; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology; D002648:Child; D004185:Disability Evaluation; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000150:complications / Q000503:physiopathology; D007263:Infusions, Parenteral / Q000379:methods; D007278:Injections, Spinal / Q000379:methods; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D016896:Treatment Outcome
D009125:Muscle Relaxants, Central; D001418:Baclofen