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Treatment of spasticity related to multiple sclerosis with intrathecal baclofen: a long-term follow-up.
J Rehabil Med. 2011 May; 43(6):511-4.JR

Abstract

BACKGROUND

Spasticity is a frequent disabling symptom in patients with multiple sclerosis, which contributes to functional deterioration.

OBJECTIVE

To evaluate the long-term effect of intrathecal baclofen therapy in multiple sclerosis-related spasticity and to evaluate the side-effects of long-term therapy, and the doses of baclofen required.

METHODS

Fourteen patients with multiple sclerosis were followed up clinically for a mean of 62 months (range 19-137 months). Clinical evaluation was made using individual goals, modified Ashworth scale, and Kurtzke Expanded Disability Status Scale.

RESULTS

Spasticity, measured with the modified Ashworth score, decreased in all patients by a mean of 1 point. The score on the Expanded Disability Status Scale improved in 2 cases. Prior to implantation, 10 patients (72%) reported severe pain. After implantation 3 improved and 7 became pain-free. The daily doses needed for treatment were highly individual. The effect of intrathecal baclofen on spasticity lasted observation time. One patient experienced progressive cognitive impairment as a side-effect of baclofen.

CONCLUSION

Intrathecal baclofen is well-tolerated and the effect lasts for up to 12 years. A thorough continuous clinical assessment is required because the differentiation between symptoms of multiple sclerosis progression and side-effects of baclofen may be difficult. Intrathecal baclofen should be considered as an option for long-term treatment of patients with advanced spasticity. Pain control can also be achieved by optimized intrathecal baclofen treatment.

Authors+Show Affiliations

Department of Neurology, Haukeland University Hospital, NO-5021 Bergen, Norway. tiina.rekand@helse-bergen.noNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21533331

Citation

Rekand, Tiina, and Marit Grønning. "Treatment of Spasticity Related to Multiple Sclerosis With Intrathecal Baclofen: a Long-term Follow-up." Journal of Rehabilitation Medicine, vol. 43, no. 6, 2011, pp. 511-4.
Rekand T, Grønning M. Treatment of spasticity related to multiple sclerosis with intrathecal baclofen: a long-term follow-up. J Rehabil Med. 2011;43(6):511-4.
Rekand, T., & Grønning, M. (2011). Treatment of spasticity related to multiple sclerosis with intrathecal baclofen: a long-term follow-up. Journal of Rehabilitation Medicine, 43(6), 511-4. https://doi.org/10.2340/16501977-0811
Rekand T, Grønning M. Treatment of Spasticity Related to Multiple Sclerosis With Intrathecal Baclofen: a Long-term Follow-up. J Rehabil Med. 2011;43(6):511-4. PubMed PMID: 21533331.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of spasticity related to multiple sclerosis with intrathecal baclofen: a long-term follow-up. AU - Rekand,Tiina, AU - Grønning,Marit, PY - 2011/5/3/entrez PY - 2011/5/3/pubmed PY - 2011/6/24/medline SP - 511 EP - 4 JF - Journal of rehabilitation medicine JO - J Rehabil Med VL - 43 IS - 6 N2 - BACKGROUND: Spasticity is a frequent disabling symptom in patients with multiple sclerosis, which contributes to functional deterioration. OBJECTIVE: To evaluate the long-term effect of intrathecal baclofen therapy in multiple sclerosis-related spasticity and to evaluate the side-effects of long-term therapy, and the doses of baclofen required. METHODS: Fourteen patients with multiple sclerosis were followed up clinically for a mean of 62 months (range 19-137 months). Clinical evaluation was made using individual goals, modified Ashworth scale, and Kurtzke Expanded Disability Status Scale. RESULTS: Spasticity, measured with the modified Ashworth score, decreased in all patients by a mean of 1 point. The score on the Expanded Disability Status Scale improved in 2 cases. Prior to implantation, 10 patients (72%) reported severe pain. After implantation 3 improved and 7 became pain-free. The daily doses needed for treatment were highly individual. The effect of intrathecal baclofen on spasticity lasted observation time. One patient experienced progressive cognitive impairment as a side-effect of baclofen. CONCLUSION: Intrathecal baclofen is well-tolerated and the effect lasts for up to 12 years. A thorough continuous clinical assessment is required because the differentiation between symptoms of multiple sclerosis progression and side-effects of baclofen may be difficult. Intrathecal baclofen should be considered as an option for long-term treatment of patients with advanced spasticity. Pain control can also be achieved by optimized intrathecal baclofen treatment. SN - 1651-2081 UR - https://www.unboundmedicine.com/medline/citation/21533331/Treatment_of_spasticity_related_to_multiple_sclerosis_with_intrathecal_baclofen:_a_long_term_follow_up_ L2 - https://www.medicaljournals.se/jrm/content/abstract/10.2340/16501977-0811 DB - PRIME DP - Unbound Medicine ER -