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

A. Leland Albright, Richard Gilmartin, Dale Swift, Linda E. Krach, Cindy B. Ivanhoe, John F. McLaughlin

Research output: Contribution to journalArticle

166 Citations (Scopus)

Abstract

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 μg/day at 2 years postimplantation, and remained relatively stable thereafter. There were no significant differences in ITB dosage in children of different ages. Adverse events potentially related to ITB therapy occurred in 50% of patients within 2 months after pump insertion and in 50% of patients thereafter; hypotonia and lethargy were the two most common adverse events. The most common complications of surgery were catheter-related problems (31%), seromas (24%), and cerebrospinal fluid leaks (15%). Conclusions. Intrathecal baclofen provides effective long-term treatment of spasticity of cerebral origin and its effects do not appear to diminish with time. This therapy is frequently associated with adverse side effects that usually can be alleviated by adjustments in dosage.

Original languageEnglish (US)
Pages (from-to)291-295
Number of pages5
JournalJournal of Neurosurgery
Volume98
Issue number2
StatePublished - Feb 1 2003

Fingerprint

Baclofen
Lower Extremity
Therapeutics
Social Adjustment
Seroma
Lethargy
Muscle Hypotonia
Time and Motion Studies
Multicenter Studies
Young Adult
Catheters
Prospective Studies
Safety

Keywords

  • Children
  • Drug delivery
  • Intrathecal baclofen
  • Spasticity

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Albright, A. L., Gilmartin, R., Swift, D., Krach, L. E., Ivanhoe, C. B., & McLaughlin, J. F. (2003). Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin. Journal of Neurosurgery, 98(2), 291-295.

Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin. / Albright, A. Leland; Gilmartin, Richard; Swift, Dale; Krach, Linda E.; Ivanhoe, Cindy B.; McLaughlin, John F.

In: Journal of Neurosurgery, Vol. 98, No. 2, 01.02.2003, p. 291-295.

Research output: Contribution to journalArticle

Albright, AL, Gilmartin, R, Swift, D, Krach, LE, Ivanhoe, CB & McLaughlin, JF 2003, 'Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin', Journal of Neurosurgery, vol. 98, no. 2, pp. 291-295.
Albright AL, Gilmartin R, Swift D, Krach LE, Ivanhoe CB, McLaughlin JF. Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin. Journal of Neurosurgery. 2003 Feb 1;98(2):291-295.
Albright, A. Leland ; Gilmartin, Richard ; Swift, Dale ; Krach, Linda E. ; Ivanhoe, Cindy B. ; McLaughlin, John F. / Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin. In: Journal of Neurosurgery. 2003 ; Vol. 98, No. 2. pp. 291-295.
@article{e9b225d4509445669b2f55bebf1eda88,
title = "Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin",
abstract = "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 μg/day at 2 years postimplantation, and remained relatively stable thereafter. There were no significant differences in ITB dosage in children of different ages. Adverse events potentially related to ITB therapy occurred in 50{\%} of patients within 2 months after pump insertion and in 50{\%} of patients thereafter; hypotonia and lethargy were the two most common adverse events. The most common complications of surgery were catheter-related problems (31{\%}), seromas (24{\%}), and cerebrospinal fluid leaks (15{\%}). Conclusions. Intrathecal baclofen provides effective long-term treatment of spasticity of cerebral origin and its effects do not appear to diminish with time. This therapy is frequently associated with adverse side effects that usually can be alleviated by adjustments in dosage.",
keywords = "Children, Drug delivery, Intrathecal baclofen, Spasticity",
author = "Albright, {A. Leland} and Richard Gilmartin and Dale Swift and Krach, {Linda E.} and Ivanhoe, {Cindy B.} and McLaughlin, {John F.}",
year = "2003",
month = "2",
day = "1",
language = "English (US)",
volume = "98",
pages = "291--295",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "2",

}

TY - JOUR

T1 - Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin

AU - Albright, A. Leland

AU - Gilmartin, Richard

AU - Swift, Dale

AU - Krach, Linda E.

AU - Ivanhoe, Cindy B.

AU - McLaughlin, John F.

PY - 2003/2/1

Y1 - 2003/2/1

N2 - 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 μg/day at 2 years postimplantation, and remained relatively stable thereafter. There were no significant differences in ITB dosage in children of different ages. Adverse events potentially related to ITB therapy occurred in 50% of patients within 2 months after pump insertion and in 50% of patients thereafter; hypotonia and lethargy were the two most common adverse events. The most common complications of surgery were catheter-related problems (31%), seromas (24%), and cerebrospinal fluid leaks (15%). Conclusions. Intrathecal baclofen provides effective long-term treatment of spasticity of cerebral origin and its effects do not appear to diminish with time. This therapy is frequently associated with adverse side effects that usually can be alleviated by adjustments in dosage.

AB - 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 μg/day at 2 years postimplantation, and remained relatively stable thereafter. There were no significant differences in ITB dosage in children of different ages. Adverse events potentially related to ITB therapy occurred in 50% of patients within 2 months after pump insertion and in 50% of patients thereafter; hypotonia and lethargy were the two most common adverse events. The most common complications of surgery were catheter-related problems (31%), seromas (24%), and cerebrospinal fluid leaks (15%). Conclusions. Intrathecal baclofen provides effective long-term treatment of spasticity of cerebral origin and its effects do not appear to diminish with time. This therapy is frequently associated with adverse side effects that usually can be alleviated by adjustments in dosage.

KW - Children

KW - Drug delivery

KW - Intrathecal baclofen

KW - Spasticity

UR - http://www.scopus.com/inward/record.url?scp=0037306726&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037306726&partnerID=8YFLogxK

M3 - Article

C2 - 12593613

AN - SCOPUS:0037306726

VL - 98

SP - 291

EP - 295

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 2

ER -