Intrathecal Baclofen Used Successfully in Ambulatory Patients With Spasticity

(Note:The term intrathecal means that the medication is injected directly into the spinal fluid with the help of a pump and a tube installed through a spinal tap. It is not used very much in children but could be efficient in adults forthe treatment of spasticity.

PHILADELPHIA (Reuters Health) May 09 - Continuous intrathecal baclofen can be used in ambulatory patients with spasticity without causing weakness or interference with other aspects of ambulation, investigators reported here at a poster session at this week's annual meeting of the American Academy of Neurology.

Drs. Andrew Sylvester and Saud A. Sadiq, of St. Luke's-Roosevelt Hospital in New York, screened 23 patients for intrathecal therapy using bolus doses of 75 µg baclofen. Even though many of the patients experienced weakness during the procedure, based on relief of their spasticity, the surgeons decided to implant pumps for continuous infusion.

The initial baclofen dose was 25 µg daily, with dose adjustment over the next several weeks up to a maximum of 1200 µg.

"The screening test is where many people are put off," Dr. Sadiq told Reuters Health. "During screening, we give baclofen as a bolus dose, which means it goes through the system like a tidal wave. Patients lose their ambulation, so they think they are not good candidates. What we've shown here is that is not the case."

Dr. Sadiq added that patients who "have good strength" will do well with continuous intrathecal infusion, as shown by up to 10 years' follow-up of this cohort.