[Results of intrathecal baclofen therapy on spasticity in patients with brain injury].
OBJECTIVE
To evaluate the results of intrathecal baclofen (ITB) therapy on the spasticity in patients with brain injury.


METHODS
Retrospective study in Brain Injury Rehabilitation Unit between January 2001 and December 2010.


RESULTS
During the last ten years, in our unit 13 patients were involved into ITB therapy on severe spasticity, after brain injury, while more than 100 Baclofen pumps were implantated in Hungary with coordination of the Multidisciplinary Team. ITB therapy was indicated in severe spasticity that developed in seven cases of traumatic brain injuries, five cases of strokes and one case of anoxic brain injury. The mean age of patients was 26 years (18-52). At the time of pump implantation three patients were in vegetative state. The shortest period elapsed between the brain injury and pump implantation was three months and the longest period was nine years, mean 15 months. Baclofen pump had to be changed in six cases after six years, and was removed in three cases due to decreasing spasticity. Catheter revision was performed in two cases due to flow problem. We had no complication in association with ITB therapy.


CONCLUSIONS
Intrathecal baclofen therapy seems to be an effective and safe treatment in patients with severe spasticity of cerebral origin. We suggest team (neurosurgeon and rehabilitation professionals) decision in a spasticity center before involving the patient into ITB therapy, and follow up in the rehabilitation unit. The severity of spasticity as a consequence of brain injury can change during years and it is necessery to follow it with dosage and dynamics of baclofen therapy. Baclofen pump removal is suggested if the ITB therapy is further not reasonable.
Országos Orvosi Rehábilitációs Intézet, Koponya-agysérültek Rehabilitációs Osztálya, 1528 Budapest. z.denes@rehabint.hu
Zoltán
Z
Dénes
András
A
Klauber
Béla
B
Both
Erőss
E
Lóránd
D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D001930:Brain Injuries / Q000150:complications*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006814:Hungary; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology* / Q000534:rehabilitation; D018458:Persistent Vegetative State / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D009125:Muscle Relaxants, Central; D001418:Baclofen