Benefit of enteral baclofen in the management of spasticity in cerebral palsy (original) (raw)

Oral baclofen in cerebral palsy: possible seizure potentiation?

Pediatric Neurology, 2003

Baclofen, a gamma-aminobutyric acid agonist, is widely used to treat spasticity of cerebral and spinal origin. Patients with both acute baclofen overdose and withdrawal have developed seizures. After several reports of new-onset seizures in children treated with oral baclofen at our institution, we reviewed our experience regarding possible effects of baclofen on seizure induction in a childhood movement disorders program over a 2-year period. Of 54 children (ages 1-10) treated with oral baclofen, 19 (35%) had a prior history of seizures. Five children (14%) developed new-onset seizures after starting baclofen. Although epilepsy is very common in children with cerebral palsy, these findings raise the possibility that baclofen may potentiate seizures in certain young children with cerebral palsy. Further study of the effects of baclofen on seizures is warranted.

Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin

Journal of Neurosurgery, 2003

Object. The goal of this study was to ascertain the long-term effectiveness and safety of intrathecal baclofen (ITB) in the treatment of spasticity of cerebral origin in children and young adults. Methods. A prospective, multicenter study was conducted in 68 patients who had been enrolled in the initial evaluation of ITB therapy and were willing to participate in long-term surveillance. Seventy-three percent of the patients were younger than 16 years of age at the time of study entry. The patients were examined at least every 3 months and were observed for an average of 70 months. At each follow-up visit, spasticity in the upper and lower extremities was evaluated by applying Ashworth scores. All adverse events and complications were recorded on standardized data forms. Spasticity in both upper and lower extremities decreased significantly (p < 0.005) and remained decreased up to 10 years. The dosage of ITB increased from a mean of 157 (µg/day 3 months after pump insertion to 300...

Role of Baclofen in Combination with Intensive Rehabilitation in Spastic Cerebral Palsy

Journal of National Institute of Neurosciences Bangladesh, 2015

Background: The treatment of cerebral palsy is multifactorial. Objective: In this study we find out the combined efficacy of baclofen and intensive rehabilitation in the treatment of spastic cerebral palsy. Methodology: This observational study was conducted over 30 patients in Dhaka Medical College Hospital from January 2011 to December 2011.The patient satisfying the inclusion and exclusion criteria was randomly enrolled in this study. They received Baclofen orally two times daily according to the body weight regularly in combination with intensive rehabilitation 1 hour daily five times a week for 24 weeks. All patients were followed up at 4 weeks interval and were evaluated for a total of 24 weeks. Result: Combination of Baclofen and intensive rehabilitation is effective in reducing tone in spastic cerebral palsy by using Modified Ashworth scale (p<0.05). Combination of Baclofen and intensive rehabilitation is also effective in joint angle improvement in spastic cerebral palsy measured by physician rating scale crouch (p<0.05) and foot contact, (p<0.05) and also improvement in gross motor function (p <0.05). Conclusion: For reduction of generalized spasticity regarding muscle tone, range of motion of the joint and improvement of gait in cerebral palsy patients, combination of Baclofen and intensive rehabilitation may be used. [

Chronic intrathecal baclofen administration for control of severe spasticity

Journal of Neurosurgery, 1990

✓ Baclofen, the most effective drug for treating spasticity, is a specific agonist of gamma-aminobutyric acid-B receptors, and is very abundant in the superficial layers of the spinal cord. Given orally, baclofen does not easily penetrate the blood-brain barrier, and is distributed equally to the brain and spinal cord. Direct intrathecal administration was given in order to change the distribution of the drug by preferentially perfusing the spinal cord. Eighteen patients presenting a severe spastic syndrome were treated with chronic intrathecal infusion of baclofen in the lumbar cerebrospinal fluid. After clinical preselection, 38 patients were implanted with a lumbar access port allowing long-term trials in order to determine the efficacy of baclofen therapy and the effective 12-hour dose. The 18 patients selected for chronic administration were implanted with a programmable pump. The pathology in these cases was: multiple sclerosis (6 cases), posttrauma spastic syndrome (eight cas...

Intrathecal Baclofen for the Treatment of Spasticity of Cerebral Origin

Journal for Specialists in Pediatric Nursing, 2003

We conducted a retrospective study of the case files of 64 multiple sclerosis (MS) patients presenting severe spasticity, who had received intrathecal (IT) baclofen test injections between 1992 and 2004 in a rehabilitation unit. In almost all cases of our series, IT baclofen was proposed to patients who were no longer able to walk. IT baclofen is a safe and effective treatment to reduce spasticity in MS patients. Despite an advanced stage of the disease at the time of pump placement, the complication rate was low and the efficacy of this treatment was maintained over time. Multiple Sclerosis 2006; 12: 101 Á/103. www.multiplesclerosisjournal.com