title: Weight gain in children with hypertonia of cerebral origin receiving intrathecal baclofen therapy.
abstract: OBJECTIVE
  To identify the pattern of weight change in children receiving intrathecal baclofen (ITB) therapy.
  
  
  METHODS
  A retrospective medical chart review was conducted to identify weight status before and after ITB pump implantation.
  
  
  METHODS
  Tertiary care children's hospital and academic medical center.
  
  
  METHODS
  All children and adolescents with hypertonia of cerebral origin who were younger than 19 years of age at the time of pump placement and followed in our pediatric baclofen pump program.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  A linear mixed model was used to examine the rate of change in weight (weight-gain velocity) before and after surgery. Weight change was adjusted for age, sex, functional level determined by the Gross Motor Functional Classification System, tube feeding, dystonia, and other comorbidities.
  
  
  RESULTS
  The average weight-gain velocity was 2.32 kg/y presurgery and 2.93 kg/y postsurgery, adjusted for potential confounders. The 0.61 kg/y increase in weight-gain velocity attained statistical significance (P = .028).
  
  
  CONCLUSIONS
  Although excessive weight gain is not a common problem in children with cerebral origin spasticity, increased weight-gain velocity is prevalent in children receiving ITB therapy. Health care providers may anticipate a welcome weight gain in the underweight child. This consequence should be considered when managing children receiving ITB therapy, and health care providers must appropriately intervene to prevent excessive weight gain. Further studies exploring the reasons for the increased weight-gain velocity are warranted.
authors.affiliation: Department of Patient Food and Nutrition Services, University of Michigan Health System, Ann Arbor, MI 48108-0744, USA.
authors.forename: Amelia A
authors.initials: AA
authors.lastname: McCoy
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Fox
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Schaubel
authors.forename: Rita N
authors.initials: RN
authors.lastname: Ayyangar
mesh_terms: D000293:Adolescent; D001418:Baclofen / Q000008:administration & dosage / Q000627:therapeutic use*; D001930:Brain Injuries / Q000150:complications; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D009122:Muscle Hypertonia / Q000188:drug therapy* / Q000209:etiology; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen