Response of intrathecal baclofen resistance to dose reduction.
Dose stabilization of intrathecal baclofen (ITB) is usually achieved within 6 to 18 months. In some patients, an increase in ITB dose may result in paradoxical unresponsiveness to baclofen. We present two cases demonstrating increased tone and functional decline with increasing ITB doses after a period of clinical stability. In both cases, reduction of ITB dose was associated with marked clinical improvement.
Cooper
Joanna A
JA
Spasticity Management Program, Alta Bates Summit Medical Center, Berkeley, CA, USA. Cooperj2@sutterhealth.org
Ridley
Barbara
B
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D001418:Baclofen / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D006429:Hemiplegia / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage* / Q000627:therapeutic use; D010146:Pain / Q000503:physiopathology; D011782:Quadriplegia / Q000188:drug therapy* / Q000503:physiopathology*; D016896:Treatment Outcome
D000700:Analgesics; D000927:Anticonvulsants; D009125:Muscle Relaxants, Central; D001418:Baclofen