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Journal articles on the topic 'Intrathecal baclofen'

Author: Grafiati

Published: 4 June 2021

Last updated: 9 February 2022

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1

Zed, Peter J., H. grant Stiver, Virginia Devonshire, Peter J. Jewesson, and Fawziah Marra. "Continuous intrathecal pump infusion of baclofen with antibiotic drugs for treatment of pump-associated meningitis." Journal of Neurosurgery 92, no. 2 (2000): 347–49. http://dx.doi.org/10.3171/jns.2000.92.2.0347.

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✓ Intrathecal baclofen administered by means of an implantable pump is being increasingly used for successful treatment of spasticity. Meningitis following intrathecally administered baclofen is a rare but serious complication that is difficult to treat without removal of the pump. Because success rates with intravenously administered antibiotic drugs for the treatment of meningitis have been low, intrathecal administration of antibiotic agents is often required to eradicate the pathogen. The authors report the case of a patient in whom Staphylococcus epidermidis meningitis developed after ins

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2

Nielsen, J. F., and T. Sinkjær. "Guided intrathecal baclofen administration by using soleus stretch reflex in moderate-severe spastic multiple sclerosis patients with implanted pump." Multiple Sclerosis Journal 10, no. 5 (2004): 521–25. http://dx.doi.org/10.1191/1352458504ms1092oa.

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We tested the hypothesis that changes in soleus stretch reflex was correlated to changes in intrathecal baclofen dose in 12 multiple sclerosis patients with moderate-severe spasticity treated with intrathecal baclofen pump. Twice patients were evaluated clinically and biomechanically. The short-latency soleus stretch reflex was elicited by rotating the ankle joint 48 with a velocity from 3.1 to 1808/s. There was a strong correlation between changes in intrathecal baclofen dose and amplitude of the short-latency stretch reflex (r=- 0.88, PB < 0.001), which means that with an increase in bacl

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3

Lewis, Kelly S., and Wade M. Mueller. "Intrathecal Baclofen for Severe Spasticity Secondary to Spinal Cord Injury." Annals of Pharmacotherapy 27, no. 6 (1993): 767–74. http://dx.doi.org/10.1177/106002809302700618.

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OBJECTIVE: To evaluate the use of intrathecal baclofen for the treatment of muscle spasticity in patients with spinal cord injury. DATA SOURCES: A MEDLINE search was used to identify relevant and pertinent literature. Information was obtained from open-label clinical trials, abstracts, conference proceedings, and review articles. Index terms in the search included baclofen, spasticity, intrathecal drug infusion, spinal cord disease, and neurosurgery. DATA EXTRACTION: Studies were selected for review if they evaluated intrathecal baclofen in patients with spinal cord injury. Emphasis was placed

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4

Ibrahim, Mohamed, John Wurpel, and Barbara Gladson. "Intrathecal Baclofen." Neurology Report 27, no. 4 (2003): 142–48. http://dx.doi.org/10.1097/01253086-200327040-00002.

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5

Ford, B., and S. Fahn. "Intrathecal baclofen." Neurology 44, no. 7 (1994): 1367. http://dx.doi.org/10.1212/wnl.44.7.1367-a.

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6

Penn, R. D. "Intrathecal baclofen." Neurology 44, no. 7 (1994): 1368. http://dx.doi.org/10.1212/wnl.44.7.1368.

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7

Kravitz, Howard M., Daniel M. Corcos, Gary Hansen, Richard D. Penn, Rosalind D. Cartwright, and Janet Gianino. "INTRATHECAL BACLOFEN." American Journal of Physical Medicine & Rehabilitation 71, no. 1 (1992): 48–52. http://dx.doi.org/10.1097/00002060-199202000-00012.

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8

Zuniga, Robert E., Sardha Perera, and Stephen E. Abram. "Intrathecal baclofen." Regional Anesthesia and Pain Medicine 27, no. 1 (2002): 90–93. http://dx.doi.org/10.1097/00115550-200201000-00015.

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9

RUSSMAN, BARRY S. "Intrathecal baclofen." Developmental Medicine & Child Neurology 52, no. 7 (2009): 601–2. http://dx.doi.org/10.1111/j.1469-8749.2009.03515.x.

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10

Vaidyanathan, Subramanian, Tun Oo, Bakul M. Soni, Peter L. Hughes, and Gurpreet Singh. "Severe, Protracted Spasm of Urinary Bladder and Autonomic Dysreflexia Caused by Changing the Suprapubic Catheter in a Cervical Spinal Cord Injury Patient: Treatment by a Bolus Dose and Increased Total Daily Dose of Intrathecal Baclofen." Clinical Medicine Insights: Case Reports 9 (January 2016): CCRep.S39117. http://dx.doi.org/10.4137/ccrep.s39117.

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Background Intrathecal administration of baclofen by implanted pump reduces rigidity and muscle spasms. Its use specifically to control bladder spasms has not been reported. Case Report A tetraplegic patient developed severe, protracted, bladder spasms, abdominal muscles spasms, and high blood pressure after change of suprapubic catheter; nifedipine, diazepam, and paracetamol did not control spasms; bolus dose of baclofen intrathecally produced prompt relief via baclofen pump. Conclusion Severe, protracted bladder spasms, abdominal muscles spasms, and autonomic dysreflexia, induced by change o

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11

Sampson, Fiona C., Andrew Hayward, Gillian Evans, Richard Morton, and Beverly Collett. "Functional benefits and cost/benefit analysis of continuous intrathecal baclofen infusion for the management of severe spasticity." Journal of Neurosurgery 96, no. 6 (2002): 1052–57. http://dx.doi.org/10.3171/jns.2002.96.6.1052.

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Object. Intrathecally delivered baclofen has been used as a treatment for severe spasticity since 1984. Despite this, there are uncertainties surrounding the benefits of treatment and the costs involved. The authors assessed the evidence of benefits and identified costs and the cost/benefit ratio for continuous intrathecal baclofen infusion in the treatment of severe spasticity. Methods. A systematic literature review was conducted to estimate the effect of continuous intrathecal baclofen infusion on function and quality-of-life (QOL) measures in patients with severe spasticity. Outcomes were

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12

Albright, A. Leland, and Susan S. Ferson. "Intraventricular baclofen for dystonia: techniques and outcomes." Journal of Neurosurgery: Pediatrics 3, no. 1 (2009): 11–14. http://dx.doi.org/10.3171/2008.10.peds0847.

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Object The aim of this study was to evaluate the use of intraventricular baclofen (IVB) for the treatment of severe generalized secondary and heredodegenerative dystonia. Methods Nine children and 1 adult with severe dystonia unresponsive to multiple oral medications were treated with IVB. Intraventricular catheters were positioned endoscopically in the third ventricle. Results Eight of the 10 patients responded to IVB; their mean dystonia scores on the Barry-Albright dystonia scale decreased from 23 to 8. The 2 patients who did not respond had not responded to previous high doses of intrathec

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13

Duhon, Bradley S., and Joel D. Macdonald. "Infusion of intrathecal baclofen for acute withdrawal." Journal of Neurosurgery 107, no. 4 (2007): 878–80. http://dx.doi.org/10.3171/jns-07/10/0878.

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✓ Acute baclofen withdrawal syndrome is a life-threatening situation that demands early recognition and urgent treatment. The current therapy of choice for this syndrome is administration of intravenous benzodiazepines, propofol, and chemical paralytic drugs until the intrathecal system can be restored. The authors present a novel technique for administering baclofen intrathecally using a lumbar drain and a standard patient-controlled analgesia pump (in continuous infusion mode). In one case, this method was used to wean the patient from high-dose intrathecal baclofen treatment. In a second ca

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14

Albright, A. Leland. "Intrathecal Baclofen in Cerebral Palsy Movement Disorders." Journal of Child Neurology 11, no. 1_suppl (1996): S29—S35. http://dx.doi.org/10.1177/0883073896011001s05.

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Intrathecal baclofen reduces spasticity in individuals with cerebral palsy. Intrathecal doses are far lower than oral doses and the effects are considerably greater, and the side effects are fewer. Response to intrathecal baclofen must be confirmed by a screening trial before implantation of a pump for chronic infusion. Intrathecal baclofen reduces spasticity in the upper and lower extremities and is often associated with improved gait and upper extremity function. Quality of life improves for patients and caregivers. The Medtronic pump has been exceedingly reliable and typically functions for

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15

Hugenholtz, Herman, Robert F. Nelson, and Eric Dehoux. "Intrathecal Baclofen – The Importance of Catheter Position." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 20, no. 2 (1993): 165–67. http://dx.doi.org/10.1017/s0317167100047776.

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ABSTRACT:In a patient receiving intrathecal baclofen injections for intractable trunk and leg spasms, positioning the subarachnoid catheter tip just caudal to the spinal segments innervating the spastic muscles enhanced the spasmolytic effect of bolus injections of intrathecal baclofen on the affected muscles. Such selective positioning of subarachnoid catheters may facilitate segmental spasmolysis with lower intrathecal doses of baclofen and provide an important alternative to relying only on ascending CSF concentration gradients of baclofen from chronic lumbar intrathecal infusion.

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16

Taira, Takaomi. "Intrathecal baclofen therapy." Rinsho Shinkeigaku 50, no. 11 (2010): 816–19. http://dx.doi.org/10.5692/clinicalneurol.50.816.

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17

Zuckerbraun, Noel S., Susan S. Ferson, A. Leland Albright, and Eva Vogeley. "Intrathecal Baclofen Withdrawal." Pediatric Emergency Care 2, no. 11 (2004): 759–64. http://dx.doi.org/10.1097/01.pec.0000144919.08619.95.

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18

Penn, Richard D. "Intrathecal Baclofen Therapy." Operative Techniques in Neurosurgery 7, no. 3 (2004): 124–27. http://dx.doi.org/10.1053/j.otns.2004.08.001.

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19

Stroud, Jason, Joseph Scattoloni, Melanie Blasingim, and Olubukola O. Nafiu. "Intrathecal baclofen toxicity." European Journal of Anaesthesiology 31, no. 6 (2014): 334–36. http://dx.doi.org/10.1097/eja.0000000000000055.

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20

Frost, Frederick, John Nanninga, Richard Penn, Suzanne Savoy, and Y. Wu. "Intrathecal Baclofen Infusion." American Journal of Physical Medicine & Rehabilitation 68, no. 3 (1989): 112–15. http://dx.doi.org/10.1097/00002060-198906000-00002.

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21

Ridley, Barbara, and Patrice Korth Rawlins. "Intrathecal Baclofen Therapy." Journal of Neuroscience Nursing 38, no. 2 (2006): 72–82. http://dx.doi.org/10.1097/01376517-200604000-00002.

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22

Merchant, John, and Gregory Hollis. "Intrathecal baclofen overdose." Emergency Medicine 9, no. 3 (2009): 221–25. http://dx.doi.org/10.1111/j.1442-2026.1997.tb00391.x.

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23

Lake, Wendell B. "Intrathecal Baclofen Infusion." Contemporary Neurosurgery 40, no. 14 (2018): 1–6. http://dx.doi.org/10.1097/01.cne.0000546556.80258.22.

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24

Awaad, Yasser, Tamer Rizk, Iram Siddiqui, Norbert Roosen, Kelly Mcintosh, and G. Michael Waines. "Complications of Intrathecal Baclofen Pump: Prevention and Cure." ISRN Neurology 2012 (March 24, 2012): 1–6. http://dx.doi.org/10.5402/2012/575168.

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Increasingly, spasticity is managed with surgically implanted Intrathecal Baclofen pumps. Intrathecal Baclofen pump revision surgery unrelated to programmable pump end-of-life is not uncommon, requiring special attention during pre-, intra-, and postoperative management. We aimed to identify and describe complications of Intrathecal Baclofen pump as well as to report avoidance and management of complications. Methods and Materials. Through 2002–2006, at the department of neurosurgery, Henry Ford and Oakwood Health Systems, Intrathecal Baclofen pumps were implanted in 44 patients: 24 children v

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25

Dalton, Catherine M., Elizabeth Keenan, Louise Jarrett, Lisa Buckley, and Valerie L. Stevenson. "The safety of baclofen in pregnancy: intrathecal therapy in multiple sclerosis." Multiple Sclerosis Journal 14, no. 4 (2008): 571–72. http://dx.doi.org/10.1177/1352458507085552.

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Intrathecal baclofen is a GABA-receptor agonist and one of the mainstay treatments of severe spasticity due to multiple sclerosis (MS). The authors report a case on the use of intrathecal baclofen administered using a Medtronic Synchromed II infusion pump. A healthy male infant (2.68 kg, Apgars 9 and 10) was born at 36 weeks gestation by cesarean section, under general anesthetic. This is the fifth reported case of intrathecal baclofen administered during pregnancy and adds to the knowledge that thus far it is relatively safe in pregnancy and may in fact be safer for the infant than oral baclo

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26

Müller-Schwefe, Gerhard, and Richard D. Penn. "Physostigmine in the treatment of intrathecal baclofen overdose." Journal of Neurosurgery 71, no. 2 (1989): 273–75. http://dx.doi.org/10.3171/jns.1989.71.2.0273.

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✓ The expanding use of intrathecal baclofen for spasticity has raised a concern about the treatment of overdose in these patients, since no specific baclofen antagonist is available. Since physostigmine has been reported to reverse the respiratory depression and somnolence due to opiates, the drug was tried for the treatment of baclofen overdose. In three cases, intravenous physostigmine (2 mg) completely reversed the respiratory depression and coma caused by boluses of 80 to 800 µg of lumbar intrathecal baclofen. Physostigmine, although not a specific antagonist, should provide increased safe

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27

Douglas, Andrea F., Howard L. Weiner, and David R. Schwartz. "Prolonged intrathecal baclofen withdrawal syndrome." Journal of Neurosurgery 102, no. 6 (2005): 1133–36. http://dx.doi.org/10.3171/jns.2005.102.6.1133.

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✓ The authors describe a patient who experienced a prolonged course of intrathecal baclofen withdrawal syndrome after removal of an implantable baclofen pump for treatment of pump infection and meningitis. The current literature outlines management options for the acute management of this syndrome. In this report the authors discuss the long-term presentation of this syndrome and suggest a treatment strategy for management of the syndrome. A 37-year-old man who presented with a baclofen pump infection and meningitis experienced acute onset of intrathecal baclofen withdrawal syndrome 12 hours a

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28

Reis, Pedro Videira, Catarina Rocha Vieira, Ana Cristina Midões, Virginia Rebelo, Paula Barbosa, and Armanda Gomes. "Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre." Acta Médica Portuguesa 32, no. 12 (2019): 754. http://dx.doi.org/10.20344/amp.10482.

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Introduction: Spasticity is a complex problem in patients with neurological disorders and may distress their quality of life. Intrathecal baclofen infusion pumps reduce spasticity with low doses and minimal side effects but are not free from complications. We aimed to evaluate the efficacy and safety of intrathecal baclofen infusion pumps as well as patients’ satisfaction.Material and Methods: Retrospective cohort study including all intrathecal baclofen infusion pumps placed up to December 2015. Demographic characteristics, clinical diagnoses, date of placement or withdrawal/replacement of in

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29

Winter, Gidon, Liana Beni-Adani, and Hilla Ben-Pazi. "Intrathecal Baclofen Therapy—Practical Approach: Clinical Benefits and Complication Management." Journal of Child Neurology 33, no. 11 (2018): 734–41. http://dx.doi.org/10.1177/0883073818785074.

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Intrathecal baclofen is an expanding accepted treatment for children with cerebral palsy and other causes of spasticity and dystonia. The aims of this review are therefore to (1) delineate the clinical benefits of intrathecal baclofen therapy in pediatric spasticity and dystonia and (2) increase awareness of the potential complications and emergency management measures of intrathecal baclofen therapy. A current literature review demonstrates the benefits and complications of this minimally invasive device. Practical guides for recognizing acute conditions and management recommendations are inc

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Romito, Jia W., Emily R. Turner, John A. Rosener, et al. "Baclofen therapeutics, toxicity, and withdrawal: A narrative review." SAGE Open Medicine 9 (January 2021): 205031212110221. http://dx.doi.org/10.1177/20503121211022197.

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Baclofen is an effective therapeutic for the treatment of spasticity related to multiple sclerosis, spinal cord injuries, and other spinal cord pathologies. It has been increasingly used off-label for the management of several disorders, including musculoskeletal pain, gastroesophageal reflux disease, and alcohol use disorder. Baclofen therapy is associated with potential complications, including life-threatening toxicity and withdrawal syndrome. These disorders require prompt recognition and a high index of suspicion. While these complications can develop following administration of either or

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31

Coffey, Robert J., David Cahill, William Steers, et al. "Intrathecal baclofen for intractable spasticity of spinal origin: results of a long-term multicenter study." Journal of Neurosurgery 78, no. 2 (1993): 226–32. http://dx.doi.org/10.3171/jns.1993.78.2.0226.

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✓ A total of 93 patients with intractable spasticity due to either spinal cord injury (59 cases), multiple sclerosis (31 cases), or other spinal pathology (three cases) were entered into a randomized double-blind placebocontrolled screening protocol of intrathecal baclofen test injections. Of the 88 patients who responded to an intrathecal bolus of 50, 75, or 100 µg of baclofen, 75 underwent implantation of a programmable pump system for chronic therapy. Patients were followed for 5 to 41 months after surgery (mean 19 months). No deaths or new permanent neurological deficits occurred as a resu

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32

Cugy, E., J. Hamonet-Torny, J. Bordes, and J. Y. Salle. "Intrathecal baclofen treatment: Perspectives." Annals of Physical and Rehabilitation Medicine 57 (May 2014): e385. http://dx.doi.org/10.1016/j.rehab.2014.03.1398.

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33

Hankey, G. J., E. G. Stewart‐Wynne, and D. Perlman. "Intrathecal baclofen for severe." Medical Journal of Australia 147, no. 5 (1987): 261. http://dx.doi.org/10.5694/j.1326-5377.1987.tb133438.x.

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34

Dralle, D., H. Müller, J. Zierski, and N. Klug. "INTRATHECAL BACLOFEN FOR SPASTICITY." Lancet 326, no. 8462 (1985): 1003. http://dx.doi.org/10.1016/s0140-6736(85)90541-0.

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35

Lantner, H., D. W. Cahill, and D. Radulescu. "Intrathecal Baclofen for Spasticity." Neurosurgery 30, no. 5 (1992): 808. http://dx.doi.org/10.1097/00006123-199205000-00053.

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36

Müller, H., U. Börner, J. Zierski, and G. Hempelmann. "INTRATHECAL BACLOFEN IN TETANUS." Lancet 327, no. 8476 (1986): 317–18. http://dx.doi.org/10.1016/s0140-6736(86)90843-3.

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37

Lantner, H., D. W. Cahill, and D. Radulescu. "Intrathecal Baclofen for Spasticity." Neurosurgery 30, no. 5 (1992): 808. http://dx.doi.org/10.1227/00006123-199205000-00053.

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38

Silbert, Peter L., and Kathryn A. Stolp-Smith. "Intrathecal Baclofen in Tetanus." Anesthesiology 79, no. 1 (1993): 199. http://dx.doi.org/10.1097/00000542-199307000-00049.

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39

MÜLLER, H., J. ZIERSKI, U. BÖRNER, and G. HEMPELMANN. "Intrathecal Baclofen in Tetanus." Annals of the New York Academy of Sciences 531, no. 1 Neurological (1988): 167–73. http://dx.doi.org/10.1111/j.1749-6632.1988.tb31823.x.

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40

Hou, Jyh-Gong G., William Ondo, and Joseph Jankovic. "Intrathecal baclofen for dystonia." Movement Disorders 16, no. 6 (2001): 1201–2. http://dx.doi.org/10.1002/mds.1215.

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41

Furr-Stimming, Erin, Allison Boyle, and Mya Schiess. "Spasticity and Intrathecal Baclofen." Seminars in Neurology 34, no. 05 (2014): 591–96. http://dx.doi.org/10.1055/s-0034-1396012.

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42

Meythaler, Jay M., Anne McCary, and Mark N. Hadley. "Prospective assessment of continuous intrathecal infusion of baclofen for spasticity caused by acquired brain injury: a preliminary report." Journal of Neurosurgery 87, no. 3 (1997): 415–19. http://dx.doi.org/10.3171/jns.1997.87.3.0415.

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✓ Twelve consecutive patients with severe spasticity and hypertonia following acquired brain injury were treated with continuous intrathecal infusion of baclofen via an implanted, programmable infusion pump—catheter system for a minimum of 3 months. In every case intrathecal baclofen therapy resulted in a statistically significant reduction in upper- and lower-extremity tone, spasm frequency, and reflexes, contributing to improved functional abilities. There were no untoward side effects or complications associated with treatment. This preliminary assessment indicates that intrathecal administ

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43

Smith, Timothy R. "Emergent Intrathecal Baclofen Withdrawal After Pseudomeningocele Aspiration." Pain Physician 2;16, no. 2;3 (2013): E113—E118. http://dx.doi.org/10.36076/ppj.2013/16/e113.

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Intrathecal baclofen (ITB) infusion has become a common treatment for severe spasticity. Many complications of these drug delivery systems have been reported such as those related to improper dosing, mechanical failure of the implanted pump or catheter, or postoperative wound issues. We report a case of ITB withdrawal after pseudomeningocele aspiration. A 21 year-old male with spastic quadriparesis due to traumatic brian injury (TBI) presented with a pseudomeningocele surrounding an ITB pump (215 mcg/day, continuous) implanted in the abdomen. The pseudomeningocele was percutaneously aspirated

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44

Aljuboori, Zaid, Jacob Archer, Wei Huff, Amee Moreno, and Andrew Jea. "Placement of baclofen pump catheter through a C1–2 puncture: technical note." Journal of Neurosurgery: Pediatrics 21, no. 4 (2018): 389–94. http://dx.doi.org/10.3171/2017.9.peds17289.

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Intrathecal baclofen has been suggested as an effective and safe treatment for intractable spasticity and dystonia. Techniques of lumbar and intraventricular catheter placement have been previously described. The purpose of this study was to describe a technique to implant catheters for intrathecal baclofen infusion through C1–2 puncture.Four of 5 consecutively treated patients underwent successful placement of catheters for intrathecal baclofen. There were no instances of infection, CSF leak, or catheter migration seen during a follow-up period of at least 6 months; furthermore, there were no

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45

Schechtmann, Gastón, Göran Lind, Jaleh Winter, Björn A. Meyerson, and Bengt Linderoth. "Intrathecal Clonidine and Baclofen Enhance the Pain-Relieving Effect of Spinal Cord Stimulation." Neurosurgery 67, no. 1 (2010): 173–81. http://dx.doi.org/10.1227/01.neu.0000370249.41634.4f.

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Abstract OBJECTIVE Spinal cord stimulation (SCS) is a well-established treatment for neuropathic pain; nevertheless, 40% of patients fail to obtain satisfactory pain relief and in many patients, the effect tends to diminish with time. Based on animal experiments, intrathecal baclofen was previously introduced clinically to enhance suboptimal SCS effects. Later animal experiments demonstrated similar data for clonidine. The aim of this study was to elucidate whether intrathecal clonidine or baclofen enhances the effect of SCS in neuropathic pain patients in whom the pain relieving-effect of SCS

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46

Gburek-Augustat, Janina, Matthias Krause, Matthias Bernhard, et al. "Unusual mechanical failures of intrathecal baclofen pump systems: symptoms, signs, and trouble shooting." Child's Nervous System 37, no. 8 (2021): 2597–604. http://dx.doi.org/10.1007/s00381-021-05154-3.

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Abstract Introduction Although intrathecal baclofen (ITB) therapy is an effective treatment for spasticity, it has several disadvantages and a risk of complications. Methods We present six pediatric patients who suffered from unusual mechanical failures of intrathecal baclofen pump systems. Results With these case-vignettes, we provide a systematic approach on how to interpret the symptoms of ITB complications and an advice which further diagnostic and therapeutic steps to follow. We underline the seriousness of baclofen overdose, underdosing or withdrawal.

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47

Hsieh, Joseph C., and Richard D. Penn. "Intrathecal baclofen in the treatment of adult spasticity." Neurosurgical Focus 21, no. 2 (2006): E5. http://dx.doi.org/10.3171/foc.2006.21.2.6.

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✓ Medical management of adult spasticity, a condition of increased muscle tone and deep tendon reflexes, is often challenging and complex. Oral medications such as baclofen often have unacceptable supraspinal side effects at effective doses. Intrathecal baclofen delivered by an implanted catheter and pump system provides good relief of spasticity while overcoming these limitations. In this paper the authors survey the use of oral and intrathecal baclofen therapy, detail the surgical process, and explain the risks and benefits of the procedure.

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48

Armstrong, Robert W., Paul Steinbok, D. Douglas Cochrane, Susan D. Kube, Susan E. Fife, and Kevin Farrell. "Intrathecally administered baclofen for treatment of children with spasticity of cerebral origin." Journal of Neurosurgery 87, no. 3 (1997): 409–14. http://dx.doi.org/10.3171/jns.1997.87.3.0409.

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✓ Management of severe spasticity in children is often a difficult problem. Orally administered medications generally offer limited benefits. This study examines the value of intrathecally administered baclofen in the treatment of 19 children with severe spasticity of cerebral origin: eight of whom sustained brain injury associated with trauma, near drowning, or cardiac arrest; 10 with cerebral palsy (spastic quadriplegia); and one child with Leigh's disease. At the time of entry into the study, patients ranged from 4 to 19 years of age, and all were completely dependent on caretakers for acti

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McCall, Todd D., and Joel D. MacDonald. "Cervical Catheter Tip Placement for Intrathecal Baclofen Administration." Neurosurgery 59, no. 3 (2006): 634–40. http://dx.doi.org/10.1227/01.neu.0000227570.40402.77.

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Abstract:

Abstract OBJECTIVE: Intrathecal baclofen can reduce congenital and posttraumatic spasticity. Traditionally, the catheter tip for baclofen delivery is placed in a low thoracic position, which can result in a lumbar-to-cisternal cerebrospinal fluid baclofen concentration gradient. We investigated whether more rostral catheter placement was technically feasible, safe, and able to control upper extremity spasticity. METHODS: The records of 48 patients with a baclofen pump were reviewed retrospectively to evaluate the safety and efficacy of cervically placed intrathecal catheters for baclofen admin

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Kawano, Osamu, Takayoshi Ueta, Hideki Ota, and Tohru Shiino. "Intrathecal Baclofen Therapy for Spasticity." Orthopedics & Traumatology 53, no. 4 (2004): 748–51. http://dx.doi.org/10.5035/nishiseisai.53.748.

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