title: Intrathecal baclofen bolus dosing and catheter tip placement in pediatric tone management.
abstract: Intrathecal baclofen (ITB), administered by an implanted pump, has emerged as an efficacious therapy for the treatment of hypertonicity in pediatrics. Although ITB has been used for more than 20 years clinically, much is still unknown about the most optimal dosing regimens and intrathecal catheter tip placement. Clinician experience, animal research, and advanced imaging is guiding the use of ITB. The rationale for high cervical catheter tip placement and pulsating flex dosing is described.
authors.affiliation: Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Rady Children's Hospital San Diego, University of California San Diego, 3020 Children's Way MC 5096, San Diego, CA 92123, USA. Electronic address: askalsky@rchsd.org.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Skalsky
authors.affiliation: Division of Pediatric Rehabilitation Medicine, Rady Children's Hospital San Diego, 3020 Children's Way, San Diego, CA 92123, USA.
authors.forename: Chrystal M
authors.initials: CM
authors.lastname: Fournier
mesh_terms: D000293:Adolescent; D001418:Baclofen / Q000008:administration & dosage* / Q000009:adverse effects; D002404:Catheterization; D002547:Cerebral Palsy / Q000150:complications*; D004334:Drug Administration Schedule; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage* / Q000009:adverse effects; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen
keywords: Bolus; Catheter; Cerebral palsy; Flex; Intrathecal baclofen; Pediatric; Spasticity