Iraqi Postgraduate Medical Journal

Current Issue

By Issue

By Subject

Keyword Index

Author Index

Indexing Databases XML

About Journal

Aims and Scope

Editorial Board

Advisory Board

Editorial Staff

Publication Ethics

Indexing and Abstracting

News

Intrathecal Baclofen Therapy Effectiveness and Side Effects: A Retrospective Study

Iraqi Postgraduate Medical Journal, 2021, Volume 20, Issue 3, Pages 227-232
10.52573/ipmj.2020.169711

Abstract

BACKGROUND:
Spasticity is a motor disorder characterized by a velocity-dependent increase in muscle tone with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as a component of the upper motor neuron syndrome.
OBJECTIVE:
To evaluate the effect of intrathecal baclofen therapy after one to five years of treatment.
PATIENTS AND METHODS:
Aretrospective questionnaire-based study was done including 20 patients operated for intrathecal baclofen pump insertion at neurosciences hospital from 1/1/2013 to 1/1/2018,
RESULTS:
According to GMFCS in C.P, only those who were grade 4 or 3 had benefit, while grade 5 patients only improved easier diapering and transfer. From 8 spinal cord injury cases, 7 had improvement, while both M.S. cases were improved, but one of them started to have tolerance four years after implantation.  Eighteen out of 20 patients were satisfied from ITB therapy
One patient suffered from side effects (nausea, drowsiness) only after the test dose, and no side effects were mentioned during continuous therapy.
Two patients had drug tolerance were required to increase the dose.
CONCLUSION:
Intrathecal baclofen is a good treatment for spasticity, it can be considered safe as it caused no serious side effects, intrathecal baclofen is safer than oral baclofen because is uses a smaller dose, and it regarding tolerance, it occurs but not in every patient.
 
Keywords:
Main Subjects:

  1. Greenberg, M. S. Handbook of neurosurgery. eighth edition. N.Y., S., D., R.d.J: Thieme; 2016.
  2. Ron L. Alterman, Andres M. Lozano, Joachim K. Krauss, and Takaomi Taira. In: Win, H., R. Youmans & win neurological surgery. seventh edition, Philadelphia. PA: Elsevier; 2017:716-738.
  3. Robert Palisano, Peter Rosenbaum, Doreen Bartlett, Michael Livingston. Gross Motor Function Classification System Expanded and Revised. [internet]. CanChild Centre for Childhood Disability Research Institute for Applied Health Sciences. 2007 [cited January 19, 2019]. Availablefrom:
    https://www.canchild.ca/system/tenon/assets/attachments/000/000/058/original/GMFCS-ER_English.pdf.
  4. Albright AL, Awaad Y, Muhonen M, et al. Performance and complications associated with the synchromed 10-ml infusion pump for the intrathecal baclofen administration in children.J Neurosurg. 2004, 101:64–68.
  5. Hussam Abou Al-Shaar, Ahmed Alkhani. Intrathecal baclofen therapy for spasticity: A compliance‑based study to indicate effectiveness. Surgical neurology international. 2016: s539-s540.
  6. INS. A Brief History of Neuromodulation. [internet] neuromodulation 2019. [cited January 26, 2019] available from https://www.neuromodulation.com/brief-history-of-neuromodulation
  7. Daniel Guillaume MD, PhD,  Anthony Van Havenbergh MD, PhD Michael Vloeberghs MD, PhD, et al, A Clinical Study of Intrathecal Baclofen Using a Programmable Pump for Intractable Spasticity. [internet] science direct 2005 [cited January 18, 2019] available from: https://www.sciencedirect.com/science/article/pii/S0003999305005629
  8. Judith L Gooch, Wende A Oberg, Barbara Grams, et al. Care provider assessment of intrathecal baclofen in children.[internet] Cambridge press 2004 [ cited January 18, 2019]. Available from https://www.cambridge.org/core/journals/developmental-medicine-and-child-neurology/article/care-provider-assessment-of-intrathecal-baclofen-in-children/D7EA37FA075A32D9A9A82AEC684EE95F
  9. S. Estrela Rego, I. Amorim, B. Condeça, F. Faria. Annals of Physical and Rehabilitation Medicine: Efficacy of a second “drug holiday” in the treatment of intrathecal baclofen tolerance – A case study. Sciencedirect. 2018; 61: e359.

10. Stempien, Lynne; Tsai, Tob.  Intrathecal Baclofen Pump Use for Spasticity: A Clinical Survey. [internet] American Journal of Physical Medicine & Rehabilitation.2000 [cited January 18, 2019]. Availablefrom: https://journals.lww.com/ajpmr/Abstract/2000/11000/Intrathecal_Baclofen_Pump_Use_for_Spasticity__A.10.aspx.

11. Peter Kan Judith Gooch Aminullah Amini, et al. Surgical treatment of spasticity in children: comparison of selective dorsal rhizotomy and intrathecal baclofen pump implantation. [internet] springer link. 2007. [cited January 18, 2019]. Available from https://link.springer.com/article/10.1007/s00381-007-0457-8

12. Heetla HW, Staal MJ, Kliphuis C, van Laar T. The incidence and management of tolerance in intrathecal baclofen therapy [internet] pubmed-NCBI 2009 [cited January 22, 2019] available from
https://www.ncbi.nlm.nih.gov/pubmed/19333246.

  • Article View: 38
  • PDF Download: 51