Research Reports - Treatment of severe, disabling spasticity with continuous intrathecal baclofen therapy following acquired brain injury

Singapore Med J. 2016 Jan;57(1):8-12. doi: 10.11622/smedj.2016005.

Wang ZM(1), Law JH(1), King NK(2), Rajeswaran DK(3), Soh S(2), Rao JP(2), Ng
WH(2), Chua KS(3).

INTRODUCTION: Intrathecal baclofen (ITB) therapy is a proven, effective treatment
for disabling cortical spasticity. We describe the first local series of five
patients with acquired brain injury (ABI) who received ITB and were followed up
for 63.8 months.
METHODS: A retrospective review of medical and rehabilitation records of patients
who received ITB therapy was carried out. Data studied included baseline
demographic and injury variables, implantation data, spasticity and function, ITB
dosage over time and complications.
RESULTS: From 2006 to 2010, a total of five patients received ITB therapy via
implanted pumps about 39.4 months after ABI. Four out of five patients
experienced significant reductions in their lower limb spasticity scores and
improvements in global function and dependency. One patient had minor adverse
events associated with baclofen-related sedation. The mean ITB dose at one year
was 182.7 ± 65.6 mcg/day.
CONCLUSION: Our preliminary study showed encouraging long-term outcomes and
safety for ITB therapy after ABI-related intractable spasticity. Individual ITB
responses over time were variable, with gender differences. The outcomes
experienced by our centre were comparable to those in the general ABI population,
supporting the efficacy of ITB therapy for chronic disabling spasticity.

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