Neurol. praxi. 2011;12(4):244-247

Intrathecal baclofen in the treatment of spasticity and dystonia in patients with cerebral palsy

MUDr.Petr Libý, Ph.D.1, MUDr.Miroslav Vaculík1, MUDr.Josef Kraus, CSc.2, PaedDr.Irena Zounková, Ph.D.3, doc.MUDr.Michal Tichý, CSc.1
1 Neurochirurgické oddělení FN Motol, Praha
2 Klinika dětské neurologie UK 2. LF a FN Motol, Praha
3 Klinika rehabilitace a tělovýchovného lékařství UK 2. LF a FN Motol, Praha

The goal of this article is to inform readers about the treatment options for severe spasticity and dystonia in children with cerebral palsy

by intrathecal baclofen (ITB). Cerebral palsy plays serious role in life of spastic child and his/her family. ITB is in position of trusted method,

which improves quality of life of spastic child with or without dystonia and so quality of life of his/her parents. Reduction of spasticity

leads to marked reduction of pain. This article presents basic indication criteria for ITB as well as basic information about baclofen test,

implantation method, refill procedure and summarizes complications of ITB therapy.

Keywords: spasticity, dystonia, cerebral palsy, baclofen pump, continuous intrathecal baklofen

Published: July 29, 2011  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Libý P, Vaculík M, Kraus J, Zounková I, Tichý M. Intrathecal baclofen in the treatment of spasticity and dystonia in patients with cerebral palsy. Neurol. praxi. 2011;12(4):244-247.
Download citation

References

  1. Albright AL. Intrathecal baclofen for childhood hypertonia. Childs Nerv Syst. 2007; 23(9): 971-979. Go to original source... Go to PubMed...
  2. Albright AL, Ferson SS. Intrathecal baclofen therapy in children. Neurosurg Focus. 2006; 21(2). Go to original source... Go to PubMed...
  3. Albright AL, Barry MJ, Shafton DH, Ferson SS. Intrathecal baclofen for generalized dystonia. Dev Med Child Neurol. 2001; 43(10): 652-657. Go to original source... Go to PubMed...
  4. Becker R, Alberti O, Bauer BL. Continuous intrathecal baclofen infusion in severe spasticity after traumatic or hypoxic brain injury. J Neurol. 1997; 244(3): 160-166. Go to original source... Go to PubMed...
  5. Coffey RJ, Edgar TS, Francisco GE, Graziani V, Meythaler JM, Ridgely PM, Sadiq SA, Turner MS. Abrupt withdrawal from intrathecal baclofen: recognition and management of a potentially life-threatening syndrome.Arch Phys Med Rehabil. 2002; 83(6): 735-741. Review. Erratum in: Arch Phys Med Rehabil 2002; 83(10): 1479. Go to original source... Go to PubMed...
  6. Dan B, Motta F, Vles JS, Vloeberghs M, Becher JG, Eunson P, Gautheron V, Lütjen S, Mall V, Pascual-Pascual SI, Pauwels P, R?ste GK. Consensus on the appropriate use of intrathecal baclofen (ITB) therapy in paediatric spasticity. Eur J Paediatr Neurol. 2010; 14(1): 19-28. Go to original source... Go to PubMed...
  7. Grabb P, Pittman A. Subfascial placement of baclofen pumps. Presented at the 27th Annual Meeting of the Section on Pediatric Neurological Surgery, Indianapolis, Indiana, December 1-4, 1998 (abstr.).
  8. Haranhalli N, Anand D, Wisoff JH, Harter DH, Weiner HL, Blate M, Roth J. Intrathecal baclofen therapy: complication avoidance and management. Childs Nerv Syst 2011; 27: 421-427. Go to original source... Go to PubMed...
  9. Hoving MA, van Raak EP, Spincemaille GH, Palmans LJ, Becher JG, Vles JS; Dutch Study Group on Child Spasticity. Efficacy of intrathecal baclofen therapy in children with intractable spastic cerebral palsy: a randomised controlled trial. Eur J Paediatr Neurol 2009; 13(3): 240-246. Go to original source... Go to PubMed...
  10. Kan P, Gooch J, Amini A, Ploeger D, Grams B, Oberg W, Simonsen S, Walker M, Kestle J. Surgical treatment of spasticity in children: comparison of selective dorsal rhizotomy and intrathecal baclofen pump implantation. Childs Nerv Syst. 2008; (2): 239-243. Go to original source... Go to PubMed...
  11. Kaňovský P, Bareš M, Severa S, Benetin J, Kraus J, Richardson A, Lisý L. Funkční přínos botulotoxinu (Dysport(R)) v léčbě dynamické spasticity u dětské mozkové obrny s pes equinus: prospektivní, multicentrická dvojitě zaslepená, placembem kontrolovaná studie. Ces Slov Neurol Neurochir 2004; 67/100: 16-23.
  12. Kolaski K, Logan LR. A review of the complications of intrathecal baclofen in patients with cerebral palsy. NeuroRehabilitation 2007; 22(5): 383-395. Review. Go to original source... Go to PubMed...
  13. Kopell BH, Sala D, Doyle WK, Feldman DS, Wisoff JH, Weiner HL. Subfascial implantation of intrathecal baclofen pumps in children: technical note. Neurosurgery 2001; 49(3): 753-756. Go to original source... Go to PubMed...
  14. Marks WA, Honeycutt J, Acosta F Jr, Reed M, Bailey L, Pomykal A, Mercer M. Dystonia due to cerebral palsy responds to deep brain stimulation of the globus pallidus internus. Mov Disord. 2011 Apr 12. doi: 10.1002/mds.23723. [Epub ahead of print]. Go to original source... Go to PubMed...
  15. Narayan RK, Loubser PG, Jankovic J, Donovan WH, Bontke CF. Intrathecal baclofen for intractable axial dystonia. Neurology 1999; 41(7): 1141-1142. Go to original source... Go to PubMed...
  16. Penn RD, Kroin JS. Intrathecal baclofen alleviates spinal cord spasticity. Lancet 1984; 1(8385): 1078. Go to original source... Go to PubMed...
  17. Sheean G. The pathophysiology of spasticity. European Journal of Neurology 2002; 9(Suppl 1): 3-9. Go to original source... Go to PubMed...
  18. Sivakumar G, Yap Y, Tsegaye M, Vloeberghs M. Intrathecal baclofen therapy for spasticity of cerebral origin-does the position of the intrathecal catheter matter? Childs Nerv Syst. 2010; 26(8): 1097-1102. Go to original source... Go to PubMed...
  19. Schapiro A, Racadio J, Kinnett D, Maugans T. Combined C-arm fluoroscopy and C-arm cone beam computed tomography for the evaluation of patients with possible intrathecal baclofen delivery system malfunctions. Neurosurgery 2011 Mar 15. [Epub ahead of print]. Go to original source... Go to PubMed...
  20. Snow BJ, Tsui JK, Bhatt MH, Varelas M, Hashimoto SA, Calne DB. Treatment of spasticity with botulinum toxin: a double-blind study. Ann Neurol 1990; 28(4): 512-515. Go to original source... Go to PubMed...
  21. Steinbok P. Selective dorsal rhizotomy for spastic cerebral palsy: a review. Childs Nerv Syst. 2007; 23(9): 981-990. Go to original source... Go to PubMed...
  22. Stetkarova I, Yablon SA, Kofler M, Stokic DS. Procedureand device-related complications of intrathecal baclofen administration for management of adult muscle hypertonia: a review. Neurorehabil Neural Repair. 2010; 24(7): 609-619. Review. Go to original source... Go to PubMed...
  23. Štětkářová I. Léčba spasticity u chronického míšního poranění. Neurol. pro praxi 2009; 10(3): 148-152.
  24. Štětkářová I, Vrba I, Peregrin J, Šroubek J. Komplikace léčby těžké spasticity implantabilními pumpovými systémy. Cesk Slov Neurol N 2008; 71/104(4): 458-465.
  25. Urgošík D, Jech R, Růžička E. Hluboká mozková stimulace u nemocných s extrapyramidovými poruchami pohybu - stereotaktická procedura a intraoperační nálezy. Ces Slov Neurol N 2011; 74/107(2): 175-186.
  26. Vender JR, Hester S, Waller JL, Rekito A, Lee MR. Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients. J Neurosurg 2006; 104(Suppl 1): 9-15. Go to original source... Go to PubMed...
  27. Ward A, Hayden S, Dexter M, Scheinberg A. Continuous intrathecal baclofen for children with spasticity and/or dystonia: Goal attainment and complications associated with treatment. J Paediatr Child Health. 2009; 45(12): 720-726. Go to original source... Go to PubMed...
  28. Ward LA. Spasticity in kids. An intrathecal option. RN 2001; 64(1): 39-41.
  29. Woon K, Tsegaye M, Vloeberghs MH. The role of intrathecal baclofen in the management of primary and secondary dystonia in children. Br J Neurosurg 2007; 21(4): 355-358. Go to original source... Go to PubMed...




Neurology for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.