Continuous intrathecal baclofen therapy in children with cerebral palsy - when does improvement emerge?
OBJECTIVE
The aim of the study was to explore the timing of effects of intrathecal baclofen therapy in children with cerebral palsy.


METHODS
Thirty five children with severe disabilities with cerebral palsy who started continuous intrathecal baclofen therapy (CITB) were followed for 18 months. Pain, number of awakenings during night, spasticity, GMFM-66 scores and PEDI scores were recorded the day before pump implantation and after 6 and 18 months of treatment respectively.


RESULTS
Introduction of CITB was associated with changes across all ICF dimensions. Reduced pain and improved sleep occurred within 6 months of treatment. Social function improved within 6 months and continued to improve until 18 months of CITB. Mobility also improved, but with a latency.


CONCLUSIONS
There seems to be a sequence of changes after introduction of continuous intrathecal baclofen in a child with cerebral palsy that may guide the multidisciplinary team in their timing of therapy during post-surgical follow-up.
Ramstad
K
K
Department of Paediatrics, Oslo University Hospital, Oslo, Norway. kjersti.ramstad@rikshospitalet.no
Jahnsen
R
R
Lofterod
B
B
Skjeldal
O H
OH
D000293:Adolescent; D001418:Baclofen / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000534:rehabilitation*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D008297:Male; D009043:Motor Activity; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy; D010147:Pain Measurement; D007319:Sleep Initiation and Maintenance Disorders; D013997:Time Factors; D016896:Treatment Outcome
D009125:Muscle Relaxants, Central; D001418:Baclofen