title: Cautious Use of Intrathecal Baclofen in Walking Spastic Patients: Results on Long-term Follow-up.
abstract: Intrathecal baclofen is presently the most effective treatment for diffuse spasticity whatever the cause. The fact that both spasticity is always accompanied by a degree of muscle weakness and that any antispastic treatment causes a decrease in muscle strength indicate that major attention must be paid in treating spasticity in ambulant patients. Methods.  We present here a retrospective study, approved by the insitutional ethics committee, of 22 ambulant spastic patients, selected as homogeneous for disease and disease duration, who were treated with intrathecal baclofen at the Istituto Nazionale Neurologico "C.Besta" in Milan. These patients were followed-up for to 15 years of treatment and their clinical assessment was enriched by the evaluation of their functional independence measurement (FIM) before and during treatment. Results.  There was improvement in quality of life as measured by the FIM scale; however, an increase in the patient's motor performance could not be detected. Conclusion.  Although we did not show any improvement in muscle performance, intrathecal baclofen did improve daily quality of life, even in spastic patients who were able to walk.
authors.affiliation: Department of Neurosurgery, Istituto Nazionale Neurologico "C.Besta", Milan, Italy.
authors.forename: Ivano
authors.initials: I
authors.lastname: Dones
authors.forename: Vittoria
authors.initials: V
authors.lastname: Nazzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tringali
authors.forename: Giovanni
authors.initials: G
authors.lastname: Broggi