[Management of increase in spasticity in patients with intrathecal baclofen pumps].
BACKGROUND
The incidence of complications after baclofen pump implantation is relatively high. Diagnosis of these complications can be difficult. A diagnostic tree would be a useful tool in cases of suspected malfunctioning of the intrathecal bacolfen infusion system and would standardise the diagnostic procedure.


METHODS
From results in the literature and the experience of our department, we designed a diagnostic tree to aid in finding the cause of a recrudescence of spasticity in patients with implanted baclofen pumps.


RESULTS
The potential causes of recrudescence of spasticity are described and a diagnostic pathway is proposed.


CONCLUSIONS
The aim of a standardised hierarchical method of diagnosis of the cause of increased spasticity in patients with intrathecal baclofen pumps is to gain time in the diagnosis and treatment. Such diagnosis should improve patient care by permitting rapid restoration of an adequate level of baclofen infusion as well as decreasing the length of hospital stay and, as a consequence, the cost relating to malfunctioning pumps.
Roche
N
N
Service de médecine physique et réadaptation, hôpital Raymond-Poincaré, APHP, université de Versailles-Saint-Quentin, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
Even-Schneider
A
A
Bussel
B
B
Bensmail
D
D
D001418:Baclofen / Q000008:administration & dosage*; D003663:Decision Trees; D018755:GABA Agonists / Q000008:administration & dosage*; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects / Q000191:economics; D007278:Injections, Spinal; D007902:Length of Stay; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000175:diagnosis* / Q000188:drug therapy*; D013686:Telemetry
D018755:GABA Agonists; D009125:Muscle Relaxants, Central; D001418:Baclofen