G E Francisco1, M M Hu, C Boake, C B Ivanhoe. 1. Physical Medicine and Rehabilitation Alliance, Baylor College of Medicine and University of Texas Health Sciences Center, Houston, TX, USA. gerard.e.francisco@uth.tmc.edu
Abstract
OBJECTIVE: To determine the efficacy and safety of early (<1 year post-disease onset) use of intrathecal baclofen (ITB). DESIGN: Consecutive case series of 14 individuals with spastic hypertonia due to trauma (5), anoxia (6) and stroke (3). MAIN OUTCOME MEASURES: Modified Ashworth (MAS) and Disability Rating (DRS) scales. INTERVENTIONS: ITB pump placement within 1 year of onset, after inadequate response to other previous treatment modalities. RESULTS: At follow-up after ITB pump implantation (mean = 13.9 months; mean daily dose = 591.5 microg per day), mean MAS scores improved from baseline by 1.0 and 2.1 points in the upper and lower limbs, respectively. DRS scores did not change significantly. Functional gains included decreased pain and improved gait speed and motor skills. The only complication was spinal leak in one subject. CONCLUSIONS: ITB therapy within 1 year of onset of acquired brain injury appears effective and safe in decreasing spastic hypertonia and does not appear to adversely affect recovery.
OBJECTIVE: To determine the efficacy and safety of early (<1 year post-disease onset) use of intrathecal baclofen (ITB). DESIGN: Consecutive case series of 14 individuals with spastic hypertonia due to trauma (5), anoxia (6) and stroke (3). MAIN OUTCOME MEASURES: Modified Ashworth (MAS) and Disability Rating (DRS) scales. INTERVENTIONS:ITB pump placement within 1 year of onset, after inadequate response to other previous treatment modalities. RESULTS: At follow-up after ITB pump implantation (mean = 13.9 months; mean daily dose = 591.5 microg per day), mean MAS scores improved from baseline by 1.0 and 2.1 points in the upper and lower limbs, respectively. DRS scores did not change significantly. Functional gains included decreased pain and improved gait speed and motor skills. The only complication was spinal leak in one subject. CONCLUSIONS:ITB therapy within 1 year of onset of acquired brain injury appears effective and safe in decreasing spastic hypertonia and does not appear to adversely affect recovery.
Authors: Steven K Dobscha; Michael E Clark; Benjamin J Morasco; Michele Freeman; Rose Campbell; Mark Helfand Journal: Pain Med Date: 2009-10 Impact factor: 3.750
Authors: Zhe Min Wang; Jia Hao Law; Nicolas Kon Kam King; Deshan Kumar Rajeswaran; Samantha Soh; Jai Prashanth Rao; Wai Hoe Ng; Karen Sui Geok Chua Journal: Singapore Med J Date: 2016-01 Impact factor: 1.858