title: Tolerance to continuous intrathecal baclofen infusion can be reversed by pulsatile bolus infusion.
abstract: METHODS
  Pilot study.
  
  
  OBJECTIVE
  To study the effect of pulsatile bolus infusion of intrathecal baclofen (ITB) on daily ITB dose, in patients showing dose increases, probably due to tolerance.
  
  
  METHODS
  Department of neurology and neurosurgery, University Medical Center Groningen, the Netherlands.
  
  
  METHODS
  Data on dosages and clinical efficacy were gathered from four patients who were switched from continuous to pulsatile bolus infusion of ITB, because of the probable diagnosis of tolerance to ITB.
  
  
  RESULTS
  Switching from continuous to pulsatile bolus infusion resulted in a decrease of the daily ITB dose, while the clinical effect could be kept stable, without introducing adverse events.
  
  
  CONCLUSIONS
  Pulsatile bolus infusion of ITB seems to be an effective and safe treatment strategy to reverse the need for increasing ITB dosages in patients with the probable diagnosis of tolerance to ITB.
authors.affiliation: Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. h.w.heetla@neuro.umcg.nl
authors.forename: H W
authors.initials: HW
authors.lastname: Heetla
authors.forename: M J
authors.initials: MJ
authors.lastname: Staal
authors.forename: T
authors.initials: T
authors.lastname: van Laar
mesh_terms: D001418:Baclofen / Q000008:administration & dosage / Q000009:adverse effects*; D004361:Drug Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D007278:Injections, Spinal / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000009:adverse effects*; D010865:Pilot Projects; D013119:Spinal Cord Injuries / Q000188:drug therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen