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Intrathecal baclofen for spasticity-related pain in amyotrophic lateral sclerosis: efficacy and factors associated with pain relief.
Muscle Nerve 2008; 37(3):396-8MN

Abstract

Clinical signs and symptoms of spasticity include hypertonia, involuntary movements (spasms, clonus), decreased range of motion, contractures, and often spasm-related pain. When spasticity is refractory to medical management, patients may be referred for intrathecal baclofen (ITB) pump placement. We reviewed a cohort of amyotrophic lateral sclerosis (ALS) patients with intractable spasticity requiring ITB to further define the impact of ITB on pain relief in this patient population. From 2003 to 2005, eight patients (mean age 43.8 years; 5 men, 3 women) with ALS received ITB for pain associated with intractable spasticity at our institution. Mean disease duration preoperatively was 47.4 months, mean follow-up was 9.8 months, and pain was evaluated using a 0-10 scoring system. All patients experienced spasticity relief in response to a preoperative bolus test injection of ITB (25-50 microg) via lumbar puncture. Following ITB pump placement, the average reduction of pain was 54% (P = 0.0082). Six patients (75%) experienced pain score reduction, three of whom had complete pain relief. Postoperative pain reduction was predicted by the degree of pain reduction following preoperative ITB test injection. These results support ITB as a treatment modality for pain associated with spasticity in ALS.

Authors+Show Affiliations

Department of Neurosurgery, University of Minnesota Medical School, Mayo Mail Code 96, 420 Delaware Street SE, Minneapolis, MN 55455, USA. mccl0285@umn.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17894358

Citation

McClelland, Shearwood, et al. "Intrathecal Baclofen for Spasticity-related Pain in Amyotrophic Lateral Sclerosis: Efficacy and Factors Associated With Pain Relief." Muscle & Nerve, vol. 37, no. 3, 2008, pp. 396-8.
McClelland S, Bethoux FA, Boulis NM, et al. Intrathecal baclofen for spasticity-related pain in amyotrophic lateral sclerosis: efficacy and factors associated with pain relief. Muscle Nerve. 2008;37(3):396-8.
McClelland, S., Bethoux, F. A., Boulis, N. M., Sutliff, M. H., Stough, D. K., Schwetz, K. M., ... Pioro, E. P. (2008). Intrathecal baclofen for spasticity-related pain in amyotrophic lateral sclerosis: efficacy and factors associated with pain relief. Muscle & Nerve, 37(3), pp. 396-8.
McClelland S, et al. Intrathecal Baclofen for Spasticity-related Pain in Amyotrophic Lateral Sclerosis: Efficacy and Factors Associated With Pain Relief. Muscle Nerve. 2008;37(3):396-8. PubMed PMID: 17894358.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrathecal baclofen for spasticity-related pain in amyotrophic lateral sclerosis: efficacy and factors associated with pain relief. AU - McClelland,Shearwood,3rd AU - Bethoux,Francois A, AU - Boulis,Nicholas M, AU - Sutliff,Matthew H, AU - Stough,Darlene K, AU - Schwetz,Kathleen M, AU - Gogol,Danuta M, AU - Harrison,Michelle, AU - Pioro,Erik P, PY - 2007/9/27/pubmed PY - 2008/5/3/medline PY - 2007/9/27/entrez SP - 396 EP - 8 JF - Muscle & nerve JO - Muscle Nerve VL - 37 IS - 3 N2 - Clinical signs and symptoms of spasticity include hypertonia, involuntary movements (spasms, clonus), decreased range of motion, contractures, and often spasm-related pain. When spasticity is refractory to medical management, patients may be referred for intrathecal baclofen (ITB) pump placement. We reviewed a cohort of amyotrophic lateral sclerosis (ALS) patients with intractable spasticity requiring ITB to further define the impact of ITB on pain relief in this patient population. From 2003 to 2005, eight patients (mean age 43.8 years; 5 men, 3 women) with ALS received ITB for pain associated with intractable spasticity at our institution. Mean disease duration preoperatively was 47.4 months, mean follow-up was 9.8 months, and pain was evaluated using a 0-10 scoring system. All patients experienced spasticity relief in response to a preoperative bolus test injection of ITB (25-50 microg) via lumbar puncture. Following ITB pump placement, the average reduction of pain was 54% (P = 0.0082). Six patients (75%) experienced pain score reduction, three of whom had complete pain relief. Postoperative pain reduction was predicted by the degree of pain reduction following preoperative ITB test injection. These results support ITB as a treatment modality for pain associated with spasticity in ALS. SN - 0148-639X UR - https://www.unboundmedicine.com/medline/citation/17894358/Intrathecal_baclofen_for_spasticity_related_pain_in_amyotrophic_lateral_sclerosis:_efficacy_and_factors_associated_with_pain_relief_ L2 - https://doi.org/10.1002/mus.20900 DB - PRIME DP - Unbound Medicine ER -