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Intrathecal baclofen

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https://www.readbyqxmd.com/read/29330080/use-of-a-pulsed-radiofrequency-energy-device-peak-plasmablade%C3%A2-in-neuromodulation-implant-revisions
#1
I Ughratdar, K A Kawsar, R Mitchell, R Selway, K Ashkan
BACKGROUND: Battery replacement or revision surgery for neuromodulation implants is conventionally performed using sharp dissection. Meticulous dissection within thick scar tissue is vital to avoid damage to surrounding lead(s) which could result in more extensive revision surgery. Traditional electrosurgery devices are contraindicated as the emitted energy can be transferred to the hardware resulting in implant or tissue damage with severe consequent complications. OBJECTIVE: We report our experience and potential applications of a novel, pulsed monopolar radiofrequency energy device (PEAK PlasmaBlade™, Medtronic plc) which facilitates dissection around implants without the risk of damaging or transmitting energy through the system...
January 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29326296/intrathecal-baclofen-therapy-versus-conventional-medical-management-for-severe-poststroke-spasticity-results-from-a-multicentre-randomised-controlled-open-label-trial-sisters
#2
Michael Creamer, Geoffrey Cloud, Peter Kossmehl, Michael Yochelson, Gerard E Francisco, Anthony B Ward, Jörg Wissel, Mauro Zampolini, Abdallah Abouihia, Nathalie Berthuy, Alessandra Calabrese, Meghann Loven, Leopold Saltuari
BACKGROUND: Intrathecal baclofen (ITB) is a treatment option for patients with severe poststroke spasticity (PSS) who have not reached their therapy goal with other interventions. METHODS: 'Spasticity In Stroke-Randomised Study' (SISTERS) was a randomised, controlled, open-label, multicentre phase IV study to evaluate the efficacy and safety of ITB therapy versus conventional medical management (CMM) with oral antispastic medications for treatment of PSS. Patients with chronic stroke with spasticity in ≥2 extremities and an Ashworth Scale (AS) score ≥3 in at least two affected muscle groups in the lower extremities (LE) were randomised (1:1) to ITB or CMM...
January 11, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29319155/economic-evaluation-and-cost-of-interventions-for-cerebral-palsy-a-systematic-review
#3
REVIEW
Sophy T F Shih, Utsana Tonmukayakul, Christine Imms, Dinah Reddihough, H Kerr Graham, Liz Cox, Rob Carter
AIM: Economic appraisal can help guide policy-making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research. METHOD: Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
January 10, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29307239/experiences-from-intrathecal-baclofen-treatment-based-on-medical-records-and-patient-and-proxy-reported-outcome-a-multicentre-study
#4
Stina Gunnarsson, Siw Alehagen, Dag Lemming, Per Ertzgaard, Shala Ghaderi Berntsson, Kersti Samuelsson
PURPOSE: To investigate patient satisfaction with intrathecal baclofen treatment, complications from the treatment, and the impact of general expectations on treatment outcome in relation to satisfaction. METHODS: A multicentre study with cross-sectional design. Data were collected through questionnaires and patient records. Patients were recruited from six outpatient intrathecal baclofen clinics in Sweden. Eighty-three patients who had been treated with intrathecal baclofen for 1-4 years were included...
January 8, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29248320/intrathecal-baclofen-in-progressive-neurological-disease-to-be-considered-before-all-other-options-fail
#5
EDITORIAL
Miss Laura Bonouvrie
No abstract text is available yet for this article.
December 8, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29232836/spasticity-management-in-disorders-of-consciousness
#6
REVIEW
Géraldine Martens, Steven Laureys, Aurore Thibaut
Background: Spasticity is a motor disorder frequently encountered after a lesion involving the central nervous system. It is hypothesized to arise from an anarchic reorganization of the pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected muscular groups. While this symptom and its management is well-known in patients suffering from stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management in patients presenting disorders of consciousness after brain damage...
December 9, 2017: Brain Sciences
https://www.readbyqxmd.com/read/29205982/spasticity-or-periodic-limb-movements
#7
Jonathan Levy, Sarah Hartley, Elsa Mauruc-Soubirac, Antoine Leotard, Frederic Lofaso, Maria-Antonia Quera-Salva, Djamel Bensmail
BACKGROUND: Spasticity and spasms are distressing features of the upper motor neuron syndrome (UMNS) following spinal cord injuries (SCI) or multiple sclerosis (MS), and have common therapeutic implications. Despite an increase of antispastic drugs and strategies, sometimes up to the surgical implant of intrathecal baclofen pump, some patients still complain of disabling spasms, which poses diagnostic and therapeutic challenges. Although clinically similar, flexor spasms due to pyramidal tract disruption must be clearly differentiated from periodic limb movements (PLM), often accompanying restless leg syndrome (RLS) and occurring during sleep...
December 4, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29192855/early-outcomes-after-intrathecal-baclofen-therapy-in-ambulatory-patients-with-multiple-sclerosis
#8
Bryan S Lee, Jaes Jones, Min Lang, Rebecca Achey, Lu Dai, Darlene A Lobel, Sean J Nagel, Andre G Machado, Francois Bethoux
OBJECTIVE Multiple sclerosis (MS) is a chronic autoimmune disease that causes demyelination and axonal loss. Walking difficulties are a common and debilitating symptom of MS; they are usually caused by spastic paresis of the lower extremities. Although intrathecal baclofen (ITB) therapy has been reported to be an effective treatment for spasticity in MS, there is limited published evidence regarding its effects on ambulation. The goal of this study was to characterize ITB therapy outcomes in ambulatory patients with MS...
December 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29174241/a-novel-skin-and-fascia-opening-for-subfascial-inserting-of-intrathecal-baclofen-pump
#9
P Fiaschi, A Cama, G Piatelli, P Moretti, M Pavanello
No abstract text is available yet for this article.
November 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29148568/intrathecal-baclofen-in-dyskinetic-cerebral-palsy-effects-on-function-and-activity
#10
Meta N Eek, Kristina Olsson, Karin Lindh, Berit Askljung, Magnus Påhlman, Olle Corneliusson, Kate Himmelmann
AIM: To investigate the effect of intrathecal baclofen (ITB) on function and activity in dyskinetic cerebral palsy (CP). METHOD: A retrospective cohort study of records from 25 children (15 males, 10 females; mean age 10y 11mo, SD 4y 9mo). Five were classified in Gross Motor Function Classification level IV and 20 in level V. Parents were interviewed about activities in daily life, sitting, communication, pain, sleep, and gross and fine motor function. Differences before and 1 year after ITB were graded as positive, no change, or negative...
November 17, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29135525/intrathecal-baclofen-injection-to-avoid-withdrawal-in-a-multiple-sclerosis-patient-undergoing-lumbar-spine-surgery-a-case-report
#11
Mirsad Dupanovic, Robert P Devine, Sean R Jackson, Sharon G Lynch
Spasticity of spinal or cerebral origin is frequently treated with baclofen. Treatment interruption initially results in rebound spasticity; life-threatening withdrawal symptoms may follow. Severe rebound spasticity of leg muscles occurred in a multiple sclerosis patient after a 10-hour long perioperative pause of oral baclofen intake. In a subsequent spine surgery, recurrence was prevented by substituting a cumulative 12-hour oral baclofen dose with an intraoperative intrathecal injection. Administration of intrathecal baclofen during prolonged surgery in patients dependent on oral baclofen may improve patient comfort and prevent early withdrawal symptoms...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29116382/selective-dorsal-rhizotomy-for-the-treatment-of-severe-spastic-cerebral-palsy-efficacy-and-therapeutic-durability-in-gmfcs-grade-iv-and-v-children
#12
Daniel D'Aquino, Ahmad A Moussa, Amr Ammar, Harshal Ingale, Michael Vloeberghs
BACKGROUND: Selective dorsal rhizotomy (SDR) has been established as an effective surgical treatment for spastic diplegia. The applicability of SDR to the full spectrum of spastic cerebral palsy and the durability of its therapeutic effects remain under investigation. There are currently limited data in the literature regarding efficacy and outcomes following SDR in Gross Motor Function Classification System (GMFCS) IV and V patients. Intrathecal baclofen has traditionally been the surgical treatment of choice for these patients...
November 7, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29115915/neuromodulation-in-multiple-sclerosis
#13
Hesham Abboud, Eddie Hill, Junaid Siddiqui, Alessandro Serra, Benjamin Walter
Neuromodulation, or the utilization of advanced technology for targeted electrical or chemical neuronal stimulation or inhibition, has been expanding in several neurological subspecialties. In the past decades, immune-modulating therapy has been the main focus of multiple sclerosis (MS) research with little attention to neuromodulation. However, with the recent advances in disease-modifying therapies, it is time to shift the focus of MS research to neuromodulation and restoration of function as with other neurological subspecialties...
November 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/29115173/role-of-gabab-receptors-and-p38mapk-nf-%C3%AE%C2%BAb-pathway-in-paclitaxel-induced-apoptosis-of-hippocampal-neurons
#14
Zhao Li, Peng Liu, Hailin Zhang, Shuang Zhao, Zi Jin, Rui Li, Yuexian Guo, Xiuli Wang
CONTEXT: The effects of the anticancer drug paclitaxel on learning and memory are rarely studied. OBJECTIVE: This study investigated changes in GABAB receptor expression during paclitaxel-induced apoptosis of hippocampal neurons and the role of the p38MAPK/NF-κB pathway in this process. MATERIALS AND METHODS: Hippocampal neurons isolated from neonatal Sprague-Dawley rats were divided into six groups: Control (C), SB (10 µL of 10-µmol/L SB203580), SN (53 µg/mL SN50), N (1 µmol/L paclitaxel), SB + N (10 µmol/L SB203580 + 1 µmol/L paclitaxel) and SN + N (53 µg/mL SN50 + 1 µmol/L paclitaxel)...
December 2017: Pharmaceutical Biology
https://www.readbyqxmd.com/read/29111148/effects-of-opioid-and-nonopioid-analgesics-on-canine-wheal-formation-and-cultured-human-mast-cell-degranulation
#15
Eric Schmidt-Rondon, Zhenping Wang, Shelle A Malkmus, Anna Di Nardo, Keith Hildebrand, Linda Page, Tony L Yaksh
Mast cell (MC) degranulation has been implicated in the side effect profile of a variety of clinically useful agents. Thus, after intrathecal delivery, formation of space-occupying, meningeally-derived masses may be related to local MC degranulation. We systematically characterized degranulating effects of opioid and nonopioid analgesics on cutaneous flares in the dog and in primary human MC (hMC) cultures. METHODS: Dogs were anesthetized with IV propofol and received intradermal (ID) injections (50μL)...
October 27, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/29101071/subarachnoid-to-subarachnoid-shunt-for-correction-of-nonfunctioning-baclofen-pump-in-a-severe-case-of-chronic-debilitating-post-spinal-cord-injury-spasticity
#16
Adewale A Bakare, Jonathan Weyhenmeyer, Albert Lee
BACKGROUND AND IMPORTANCE: Perhaps the most disabling condition seen in patients with spinal cord injury is spasticity. Spasticity is characterized as hyperreflexia and hypertonicity as a result of damage to the supraspinal tracts in the aftermath of SCI. Intrathecal baclofen (ITB) is the mainstay therapy for spasticity unresponsive to oral baclofen. One of the problems associated with post-SCI spasticity unresponsive to ITB is development of scar tissue that prevents the diffusion of baclofen in the desired spinal cord area...
October 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29079488/generalized-itching-and-lower-extremity-spasticity-in-a-patient-with-intrathecal-baclofen-pump
#17
Motunrayo Mobolaji-Lawal, Rittik Chaudhuri, Regan H Marsh, Emily S Miller, Kriti Bhatia
No abstract text is available yet for this article.
October 24, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29050720/does-intrathecal-baclofen-therapy-increase-prevalence-and-or-progression-of-neuromuscular-scoliosis
#18
Kevin R Walker, Susan A Novotny, Linda E Krach
STUDY DESIGN: Retrospective, case-matched review. OBJECTIVES: Compare a group of individuals with cerebral palsy (CP) who had intrathecal baclofen (ITB) pumps to a group of individuals with CP who did not have ITB pumps in order to determine if there was a difference in the prevalence of new-onset neuromuscular scoliosis, an increased rate of progression of preexisting neuromuscular scoliosis, or an increased rate of posterior spine fusion surgery in skeletally immature individuals with CP who had ITB pumps...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29043456/correction-to-careful-reprogramming-of-baclofen-intrathecal-programmable-synchromed-infusion-pumps-at-their-replacement-in-a-series-of-156-patients
#19
Ivano Dones, Giuseppe Messina, Angelo Franzini
The original version of this article unfortunately contained mistakes. The names of all authors are inadvertently inverted and are now corrected in the authorgroup of this article.
December 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28964670/intrathecal-baclofen-treatment-an-option-in-x-linked-adrenoleukodystrophy
#20
Helgi Thor Hjartarson, Christoffer Ehrstedt, Kristina Tedroff
BACKGROUND: X-linked adrenoleukodystrophy (X-ALD) is a genetic peroxisomal disorder associated with tissue accumulation of very long chain fatty acids (VLCFAs). In approximately one third of affected males, this causes progressive and irreversible damage to the brain white matter. Progress is often rapid with upper motor neuron damage leading to severe spasticity and dystonia. The increased muscle tone is frequently difficult to alleviate with oral drugs. Here, we describe two patients with X-ALD who have received treatment with intrathecal baclofen pumps (ITB)...
September 14, 2017: European Journal of Paediatric Neurology: EJPN
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