title: Opisthotonus and intrathecal treatment with baclofen (ITB) in children.
abstract: Opisthotonus is a relatively rare, but challenging neurological symptom of spasticity or dystonia that most often results from a dramatic event such as near-drowning. The classic treatment option for opisthotonus is the oral administration of medication such as benzodiazepines and baclofen. However, results with these medications are usually not very beneficial. Numerous studies however have shown that intrathecal treatment with baclofen (ITB) is an efficient and safe treatment for generalized therapy-resistant spasticity, even in children. In this retrospective study, we describe 11 children (mean age 9 years) with pronounced opisthotonus and quadriplegia caused by different types of acquired lesions who were treated with intrathecal baclofen. Results show that in addition to an expected decrease in muscle tonus, there was also a clear improvement in patient comfort and nursing. A remarkable weight gain was observed in most patients, even when calorie intake did not change. This increase in weight might be due to a reduction in energy expenditure as a result of the decrease in spasticity. Intrathecal treatment with baclofen should be considered in every child with opisthotonus.
authors: Rehabilitation and Epilepsy Centre for Children and Youth, Reebergenlaan 4, B - 2242 Pulderbos, Belgium. berten.ceulemans@revapulderbos.be
authors: Berten
authors: B
authors: Ceulemans
authors: Johanna
authors: J
authors: van Rhijn
authors: Sandra
authors: S
authors: Kenis
authors: Ria
authors: R
authors: Krols
authors: Annick
authors: A
authors: Laridon
authors: Tony
authors: T
authors: Van Havenbergh
mesh_terms: D000293:Adolescent; D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D001530:Belgium; D002648:Child; D002675:Child, Preschool; D004421:Dystonia / Q000150:complications / Q000188:drug therapy*; D004827:Epilepsy / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000150:complications / Q000188:drug therapy*; D011782:Quadriplegia / Q000188:drug therapy*; D012189:Retrospective Studies; D012600:Scoliosis / Q000209:etiology; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen
references: Dev Med Child Neurol. 2001 Apr;43(4):277-8
references: 11305407
references: Neurosurg Focus. 2006 Aug 15;21(2):e3
references: 16918224
references: Mov Disord. 2006 Jun;21(6):868-9
references: 16532457
references: Dev Med Child Neurol. 1993 Nov;35(11):997-1006
references: 8224567
references: Dev Med Child Neurol. 2004 Nov;46(11):788-9
references: 15540643
references: J Neurosurg. 1998 Jun;88(6):1009-13
references: 9609295
references: Dev Med Child Neurol. 2002 Oct;44(10):660-5
references: 12418790
references: Arch Phys Med Rehabil. 2006 Nov;87(11):1503-8
references: 17084127
references: Arch Phys Med Rehabil. 2003 Aug;84(8):1194-9
references: 12917859
references: Arch Phys Med Rehabil. 1996 Jan;77(1):35-9
references: 8554471