Long-term safety and efficacy of continuous intrathecal baclofen.

Journal Article (Journal Article)

Long-term continuous intrathecal baclofen (CITB) infusion is a treatment option used to manage otherwise intractable spasticity and is delivered via an implantable pump. The purpose of this single-center multidisciplinary review was to report on the long-term safety and efficacy of CITB in the treatment of 21 children with intractable severe spasticity of cerebral origin. Nineteen recipients had spastic quadriplegia and two had spastic diplegia. Seven recipients had level IV severity on the Gross Motor Functional Classification System and 14 had level V. Median age at implantation was 12 years (range 4 to 20). Fifteen recipients were male, 6 were female. Seventeen recipients were alive at the end of the follow-up period (31 to 78 months; mean 53, SD 4). The Ashworth scale showed a substantial decrease in spasticity in the upper and lower extremities at 6 months and at the most recent follow-up. The Gross Motor Function Measure and Pediatric Evaluation of Disability Inventory showed no functional change. Most treatment goals were at least partly achieved. Caregivers reported a reduction in use of oral medication for spasticity, and improvements in comfort, function, and ease of care. Caregiver satisfaction was high. During 80 recipient-years of pump operation, 153 treatment-associated adverse events occurred: 27 of these were device-related. There were four deaths unrelated to CITE, including one from acute pancreatitis. Our findings might assist in establishing patient selection criteria and treatment goals, improving patient follow-up, and monitoring adverse events.

Full Text

Duke Authors

Cited Authors

  • Campbell, WM; Ferrel, A; McLaughlin, JF; Grant, GA; Loeser, JD; Graubert, C; Bjornson, K

Published Date

  • October 2002

Published In

Volume / Issue

  • 44 / 10

Start / End Page

  • 660 - 665

PubMed ID

  • 12418790

International Standard Serial Number (ISSN)

  • 0012-1622

Digital Object Identifier (DOI)

  • 10.1017/s0012162201002729

Language

  • eng

Conference Location

  • England