title: Long-term effects of intrathecal baclofen in multiple sclerosis.
abstract: OBJECTIVE
  Spasticity is associated with various neurological conditions. In this study the authors analyzed the long term effects of intrathecal baclofen therapy in multiple sclerosis and evalued the benefits of the treatment on spasticity, disability, pain, spasm frequency and rated the incidence of side effects.
  
  
  METHODS
  A records of 123 patients, with a severe, progressive and refractory to medical therapy spasticity from different causes, underwent baclofen pump placement, after a bolus test, from 2000 to 2012,under Department of Neurosurgery at the Second University of Naples/Italy. We present our experience in treating 28 subjects that was affected by multiple sclerosis. For all patients we reviewed long-term response to therapy, surgical technique, surgery- and pump-related complications. Every patients were evaluated by means of the Modified Ashworth Scale (MAS), Penn Spasm Frequency Scale (SFS), Visual analogue Scale For Pain (VAS), Barthel index (BI) and Self Rating Depression Scale (SDS) RESULTS: During follow up the mean MAS score for upper and lower extremities decrease significantly. Also SFS's decrease was statistically significant. This resulted in a dramatic improvement of BI. Furthermore, we observed a marked improvement in VAS and SDS.
  
  
  CONCLUSIONS
  Intrathecal baclofen provides effective long-term treatment of spasticity multiple sclerosis related. ITB therapy increases the quality of lifestyle and functional independence in appropriately selected cases.
authors.affiliation: Department of Neurosurgery, Second University of Naples, SUN, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Natale
authors.affiliation: Department of Neurosurgery, Second University of Naples, SUN, Italy. Electronic address: doriantonioraf@libero.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: D'Oria
authors.affiliation: Department of Neurosurgery, Second University of Naples, SUN, Italy.
authors.forename: Veronica Venera
authors.initials: VV
authors.lastname: Nero
authors.affiliation: Department of Neurosurgery, Second University of Naples, SUN, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Squillante
authors.affiliation: Department of Neurosurgery, Second University of Naples, SUN, Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: Gentile
authors.affiliation: Department of Neurosurgery, Second University of Naples, SUN, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Rotondo
mesh_terms: D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen
keywords: Intrathecal baclofen; Multiple sclerosis; Outcome; Spasticity