title: [Treatment of severe spacticity in multiple sclerosis by continuous intrathecal baclofen].
abstract: BACKGROUND
  Successful treatment of severe spasticity represents an imperative of symptomatic therapy of multiple sclerosis (MS) due to a significant improvement of physical, psychic and social rehabilitation of MS patients, as well as a long-term cost savings for the additional treatments of conditions arising from uncontrolled severe spasticity. Continuous intrathecal administration of baclofen (ITB), using a subcutaneously implanted programmable infusion pump, is a minimally invasive, reversible method for the treatment of severe diffuse spasticity of the spinal origin.
  
  
  METHODS
  The first two cases in our country, treated by ITB due to severe spasticity caused by MS, were reported. Despite the local complications of surgical wound healing above the implanted components of the ITB-system in one patient, the optimal reduction of spasticity the with complete elimination of spastic pain was obtained in both patients.
  
  
  CONCLUSIONS
  Our initial experiences confirmed ITB as a safe and effective therapeutical option for the treatment of intractable spasticity in patients with MS. Major prerequisites for this were adequate patient selection and good control of the basic disease. The use of the minimal invasive implantation technique and the experience in choosing of the adequate ITB-system components, could successfully prevent the occurrence of local complications related to the impaired healing of the ITB-system implantation site.
authors.affiliation: Vojnomedicinska akademija, Klinika za neurohirurgiju, Beograd, Srbija i Crna Gora.
authors.forename: Predrag
authors.initials: P
authors.lastname: Perić
authors.forename: Branislav
authors.initials: B
authors.lastname: Antić
authors.forename: Evica
authors.initials: E
authors.lastname: Dincić
authors.forename: Dragana
authors.initials: D
authors.lastname: Obradović
authors.forename: Stojanka
authors.initials: S
authors.lastname: Arsić
mesh_terms: D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen