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Treatment of severe, disabling spasticity with continuous intrathecal baclofen therapy following acquired brain injury: the experience of a tertiary institution in Singapore.
Singapore Med J. 2016 Jan; 57(1):8-12.SM

Abstract

INTRODUCTION

Intrathecal baclofen (ITB) therapy is a proven, effective treatment for disabling cortical spasticity. We describe the first local series of five patients with acquired brain injury (ABI) who received ITB and were followed up for 63.8 months.

METHODS

A retrospective review of medical and rehabilitation records of patients who received ITB therapy was carried out. Data studied included baseline demographic and injury variables, implantation data, spasticity and function, ITB dosage over time and complications.

RESULTS

From 2006 to 2010, a total of five patients received ITB therapy via implanted pumps about 39.4 months after ABI. Four out of five patients experienced significant reductions in their lower limb spasticity scores and improvements in global function and dependency. One patient had minor adverse events associated with baclofen-related sedation. The mean ITB dose at one year was 182.7 ± 65.6 mcg/day.

CONCLUSION

Our preliminary study showed encouraging long-term outcomes and safety for ITB therapy after ABI-related intractable spasticity. Individual ITB responses over time were variable, with gender differences. The outcomes experienced by our centre were comparable to those in the general ABI population, supporting the efficacy of ITB therapy for chronic disabling spasticity.

Authors+Show Affiliations

Yong Loo Lin School of Medicine, National University of Singapore, Singapore.Yong Loo Lin School of Medicine, National University of Singapore, Singapore.Department of Neurosurgery, National Neuroscience Institute, Singapore.Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore.Department of Neurosurgery, National Neuroscience Institute, Singapore.Department of Neurosurgery, National Neuroscience Institute, Singapore.Department of Neurosurgery, National Neuroscience Institute, Singapore.Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26831310

Citation

Wang, Zhe Min, et al. "Treatment of Severe, Disabling Spasticity With Continuous Intrathecal Baclofen Therapy Following Acquired Brain Injury: the Experience of a Tertiary Institution in Singapore." Singapore Medical Journal, vol. 57, no. 1, 2016, pp. 8-12.
Wang ZM, Law JH, King NK, et al. Treatment of severe, disabling spasticity with continuous intrathecal baclofen therapy following acquired brain injury: the experience of a tertiary institution in Singapore. Singapore Med J. 2016;57(1):8-12.
Wang, Z. M., Law, J. H., King, N. K., Rajeswaran, D. K., Soh, S., Rao, J. P., Ng, W. H., & Chua, K. S. (2016). Treatment of severe, disabling spasticity with continuous intrathecal baclofen therapy following acquired brain injury: the experience of a tertiary institution in Singapore. Singapore Medical Journal, 57(1), 8-12. https://doi.org/10.11622/smedj.2016005
Wang ZM, et al. Treatment of Severe, Disabling Spasticity With Continuous Intrathecal Baclofen Therapy Following Acquired Brain Injury: the Experience of a Tertiary Institution in Singapore. Singapore Med J. 2016;57(1):8-12. PubMed PMID: 26831310.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of severe, disabling spasticity with continuous intrathecal baclofen therapy following acquired brain injury: the experience of a tertiary institution in Singapore. AU - Wang,Zhe Min, AU - Law,Jia Hao, AU - King,Nicolas Kon Kam, AU - Rajeswaran,Deshan Kumar, AU - Soh,Samantha, AU - Rao,Jai Prashanth, AU - Ng,Wai Hoe, AU - Chua,Karen Sui Geok, PY - 2016/2/3/entrez PY - 2016/2/3/pubmed PY - 2017/1/25/medline KW - dystonia KW - hypertonia KW - intrathecal baclofen pump KW - spasticity KW - traumatic brain injury SP - 8 EP - 12 JF - Singapore medical journal JO - Singapore Med J VL - 57 IS - 1 N2 - INTRODUCTION: Intrathecal baclofen (ITB) therapy is a proven, effective treatment for disabling cortical spasticity. We describe the first local series of five patients with acquired brain injury (ABI) who received ITB and were followed up for 63.8 months. METHODS: A retrospective review of medical and rehabilitation records of patients who received ITB therapy was carried out. Data studied included baseline demographic and injury variables, implantation data, spasticity and function, ITB dosage over time and complications. RESULTS: From 2006 to 2010, a total of five patients received ITB therapy via implanted pumps about 39.4 months after ABI. Four out of five patients experienced significant reductions in their lower limb spasticity scores and improvements in global function and dependency. One patient had minor adverse events associated with baclofen-related sedation. The mean ITB dose at one year was 182.7 ± 65.6 mcg/day. CONCLUSION: Our preliminary study showed encouraging long-term outcomes and safety for ITB therapy after ABI-related intractable spasticity. Individual ITB responses over time were variable, with gender differences. The outcomes experienced by our centre were comparable to those in the general ABI population, supporting the efficacy of ITB therapy for chronic disabling spasticity. SN - 0037-5675 UR - https://www.unboundmedicine.com/medline/citation/26831310/Treatment_of_severe_disabling_spasticity_with_continuous_intrathecal_baclofen_therapy_following_acquired_brain_injury:_the_experience_of_a_tertiary_institution_in_Singapore_ L2 - https://sma.org.sg/UploadedImg/files/SMJ/5701/5701a1.pdf DB - PRIME DP - Unbound Medicine ER -