Effect of intrathecal baclofen on dystonia in children with cerebral palsy and the use of functional scales.
BACKGROUND
The literature available shows that spasticity in patients with cerebral palsy (CP) is reduced by intrathecal baclofen (ITB) treatment, and various studies suggest that this treatment can also be used in dystonic patients. The aim of the present study was to evaluate dystonia treated with ITB in children with CP.


METHODS
Data of 19 patients affected by dystonia as an outcome of infant CP in patients belonging to level V of Gross Motor Function Classification System treated with ITB were collected. The mean age at implant is 8.49 years.The patients are assessed using Barry-Albright Scale and Burke-Fahn-Marsden Scale before treatment and at 3, 6, and 12 months postimplant.


RESULTS
The results showed a statistically significant improvement (P < 0.001) in the total scores of the 2 scales after just 3 months of treatment, an improvement that was maintained for the 1-year period of follow-up. The results also revealed a reduction in dystonias, an improvement in posture, and an easing of the task of the caregivers in managing the patient as a result of treatment with ITB.


CONCLUSIONS
In patients belonging to level V of Gross Motor Function Classification System and treated with ITB, a decrease in frequency and severity of dystonia is observed. This improvement eases caregiver in patient management.


METHODS
Therapeutic Level IV.
Motta
Francesco
F
Department of Pediatric Orthopedics, V. Buzzi Children's Hospital, Via Castelvetro 32, Milan, Italy. f.motta@icp.mi.it
Stignani
Cecilia
C
Antonello
Clara Eleonora
CE
D000293:Adolescent; D001418:Baclofen / Q000008:administration & dosage*; D017028:Caregivers; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D004421:Dystonia / Q000188:drug therapy* / 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*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D009125:Muscle Relaxants, Central; D001418:Baclofen