Intrathecal Baclofen in Spinal Spasticity: Frequency and Severity of Withdrawal Syndrome
Language English Country United States Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
26218954
Knihovny.cz E-resources
- MeSH
- Substance Withdrawal Syndrome diagnosis drug therapy etiology MeSH
- Baclofen administration & dosage adverse effects therapeutic use MeSH
- Muscle Relaxants, Central administration & dosage adverse effects therapeutic use MeSH
- Adult MeSH
- Infusion Pumps, Implantable MeSH
- Catheters MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Spinal Diseases complications drug therapy MeSH
- Spinal Cord Injuries complications MeSH
- Multiple Sclerosis complications MeSH
- Equipment Failure MeSH
- Injections, Spinal MeSH
- Muscle Spasticity complications drug therapy MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Baclofen MeSH
- Muscle Relaxants, Central MeSH
BACKGROUND: Intrathecal baclofen (ITB) delivered by programmable pump devices represents an important modality for long-term treatment of severe spinal spasticity. OBJECTIVE: One of the serious adverse events is a withdrawal syndrome after sudden interruption of ITB delivery. In this study, we analyzed the frequency and severity of this complication. Treatment recommendations follow. STUDY DESIGN: Case study. SETTING: Academic medical center. METHODS: A total of 54 ITB pumps were successfully implanted in 39 patients with severe intractable spasticity (24 with spinal cord injury, 15 with multiple sclerosis, 24 men, age range 21-59 years). RESULTS: Eight patients developed a withdrawal syndrome on total a daily dose of ITB between 90-420 μg/day. Seven patients had catheter-related complications. In one patient, pump failure was observed due to its corrosion. Within the group, baclofen withdrawal syndrome occurred once in 20.1 pump-years counted out of 160.4 pump-years of ITB treatment. LIMITATIONS: Small sample size. CONCLUSIONS: ITB withdrawal syndrome is a rare but life-threatening event and prompt diagnosis before treatment initiation is critical. The reported events were mostly mild due to the acute treatment regime and probably due to a lower dose of ITB. A prerequisite for successful ITB treatment is a deep knowledge of complications and their prompt management in the hands of a multidisciplinary team in specialized centers.
