title: Intrathecal baclofen therapy for the symptomatic treatment of hereditary spastic paraplegia.
abstract: OBJECTIVE
  We study the effectiveness and safety of intrathecal baclofen therapy for the treatment of spasticity and gait improvement in patients suffering from hereditary spastic paraplegia.
  
  
  METHODS
  Sixteen patients diagnosed with hereditary spastic paraplegia (mean age: 43 years) were enrolled in this open prospective study. The main inclusion criteria were: spastic paraparesis with a negative laboratory and imaging work-up (apart from spinal cord atrophy), unsuccessful trial of oral anti-spasticity drugs. An intrathecal baclofen trial was initially performed and a pump for the intrathecal administration of baclofen was implanted to the patients who responded favorably to the baclofen trial. The patients were followed for lower limbs' spasticity, walking performance and complications.
  
  
  RESULTS
  Fourteen patients had a positive baclofen trial and were submitted to the implantation of the baclofen pump. The average follow-up period was 25.8 months. All patients had a reduction in lower limbs' spasticity measured in the modified Ashworth scale from 2.6 (±0.8) to 0.7 (±0.9) (p=.000). Walking ability was improved in a modified version of the functional walking scale of the Gillette Functional Assessment Questionnaire from 5.9 (±1.7) to 7.4 (±2.0) (p=.001). Two patients had to be re-operated due to a catheter fracture.
  
  
  CONCLUSIONS
  Intrathecal baclofen can offer an improvement in spasticity and in the walking performance in patients suffering from hereditary spastic paraplegia. The underlying residual motor function and the patient's adherence to the rehabilitation program might contribute to the post-operative improvement of gait.
authors: 1st Department of Neurosurgery, University of Athens Medical School, Athens, Greece. Electronic address: konstantinmarg@yahoo.com.
authors: Konstantinos
authors: K
authors: Margetis
authors: 1st Department of Neurosurgery, University of Athens Medical School, Athens, Greece.
authors: Stefanos
authors: S
authors: Korfias
authors: 1st Department of Neurosurgery, University of Athens Medical School, Athens, Greece.
authors: Nikolaos
authors: N
authors: Boutos
authors: 1st Department of Neurosurgery, University of Athens Medical School, Athens, Greece.
authors: Stylianos
authors: S
authors: Gatzonis
authors: 1st Department of Neurosurgery, University of Athens Medical School, Athens, Greece.
authors: Marios
authors: M
authors: Themistocleous
authors: 1st Department of Neurosurgery, University of Athens Medical School, Athens, Greece.
authors: Anna
authors: A
authors: Siatouni
authors: 1st Department of Neurosurgery, University of Athens Medical School, Athens, Greece.
authors: Zoi
authors: Z
authors: Dalivigka
authors: 1st Department of Neurosurgery, University of Athens Medical School, Athens, Greece.
authors: Theofanis
authors: T
authors: Flaskas
authors: 1st Department of Neurosurgery, University of Athens Medical School, Athens, Greece.
authors: George
authors: G
authors: Stranjalis
authors: 2nd Department of Neurosurgery, University of Athens Medical School, Athens, Greece.
authors: Efstathios
authors: E
authors: Boviatsis
authors: 1st Department of Neurosurgery, University of Athens Medical School, Athens, Greece.
authors: Damianos
authors: D
authors: Sakas
mesh_terms: D000328:Adult; D001418:Baclofen / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal / Q000379:methods; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy*; D011446:Prospective Studies; D015419:Spastic Paraplegia, Hereditary / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016138:Walking; D055815:Young Adult
chemical_list: D001418:Baclofen
keywords: Baclofen; GABA-B receptor; Hereditary spastic paraplegia; Intrathecal injection