RESUMO
In 19 patients, who suffered from severe spinal spasticity of different etiologies and did not respond sufficiently to oral antispastic therapy, intrathecal Baclofen test boli were administered. In 11 patients a DAD (Drug Administration Device) [SynchroMedR Model 8611 H, Medtronic Inc. Minneapolis, USA] was implanted. Catheter dislocation or torsion was the most common complication to be observed in these 11 patients. Long term intrathecal Baclofen application was effective in all patients, as reducing spasticity, flexor spasms and spasm induced pain. In some cases the motor performance ameliorated.
Assuntos
Baclofeno/uso terapêutico , Esclerose Múltipla/complicações , Espasticidade Muscular/tratamento farmacológico , Traumatismos da Coluna Vertebral/complicações , Adulto , Baclofeno/administração & dosagem , Baclofeno/efeitos adversos , Feminino , Seguimentos , Hemangioma/complicações , Humanos , Bombas de Infusão/efeitos adversos , Injeções Espinhais , Masculino , Espasticidade Muscular/etiologia , Reflexo Anormal/efeitos dos fármacos , Neoplasias da Coluna Vertebral/complicações , Micção/efeitos dos fármacosRESUMO
Baclofen, a derivate of gamma-amino butyric acid (GABA), is known to be a useful drug in spasticity treatment. To achieve a good therapeutic response higher oral dosages have to be administered related with central side effects. Intrathecal application of Baclofen in microgram range dosages is proved to be effective in spinal spasticity. The efficiency of intrathecal Baclofen in patients suffering from supraspinal spasticity is discussed controversially. We report on 9 patients with long-term intrathecal Baclofen treatment, all of them responding well presenting a marked reduced muscle tone. In most cases an improvement of motor performance and in two cases improved bladder function was observed. The therapeutical dosages administered to patients with supraspinal spasticity exceed those administered to patients with spinal spasticity by approximately 100% without provoking central side effects. Despite the risks connected with this method it has to be considered as treatment of choice in cases of severe supraspinal spasticity.
