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Intrathecal baclofen

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https://www.readbyqxmd.com/read/29782907/analgesic-effect-of-intrathecal-baclofen-bolus-on-neuropathic-pain-in-spinal-cord-injury-patients
#1
Hatice Kumru, Jesus Benito-Penalva, Markus Kofler, Joan Vidal
BACKGROUND: GABA-ergic neurons are widely distributed throughout the central nervous system, including the spinal cord which is important for the transmission of pain impulses to the brain. Here we hypothesized that intrathecal baclofen (ITB) which is a GABA analogue might exert analgesic effects on neuropathic pain, which could be related to subtypes of pain in spinal cord injury (SCI). METHODS: SCI patients with a cervical or thoracic lesion and neuropathic pain were randomized to receive either a single ITB bolus or placebo...
May 18, 2018: Brain Research Bulletin
https://www.readbyqxmd.com/read/29761017/eleven-years-experience-with-intrathecal-baclofen-complications-risk-factors
#2
Elke Pucks-Faes, Gabriel Hitzenberger, Heinrich Matzak, Elena Fava, Giulio Verrienti, Ilse Laimer, Josef Fritz, Leopold Saltuari
Objective: Treatment with intrathecal baclofen (ITB) is commonly used in patients with severe spasticity. However, complications may occur after implantation of the ITB-device, albeit mainly procedure- and device-related problems. The aim of the study was to assess surgical- as well as catheter- and pump-related complications and define their risk factors. Methods: We retrospectively evaluated all patients with an implanted ITB-device who were treated at the Department of Neurology, Hochzirl Hospital, Zirl, Austria, between 2006 and 2016...
May 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29753900/dorsal-longitudinal-t-myelotomy-bischof-ii-technique-a-useful-antiquated-procedure-for-treatment-of-intractable-spastic-paraplegia
#3
Bunpot Sitthinamsuwan, Inthira Khampalikit, Luckchai Phonwijit, Akkapong Nitising, Sarun Nunta-Aree, Sirilak Suksompong
OBJECTIVE: Dorsal longitudinal T-myelotomy is a long-established operation to treat severe spastic paraplegia. The present study aimed to report this surgical technique and investigate the efficacy of T-myelotomy for spasticity relief. METHODS: All cases undergoing T-myelotomy for treatment of intractable spastic paraplegia during 2009-2017 were included. The spasticity severity was evaluated using the Modified Ashworth Scale (MAS), Penn Spasm Frequency Scale (PSFS), Adductor Tone Rating Scale (ATRS), degree of passive range of motion (PROM), and occurrence of abdominal muscle spasms...
May 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29708914/intrathecal-baclofen-injection-to-avoid-withdrawal-in-a-multiple-sclerosis-patient-undergoing-lumbar-spine-surgery-a-case-report
#4
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...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29574822/balancing-the-benefits-of-intrathecal-baclofen-pump-surgery-with-potential-postoperative-complications
#5
Kristin Buxton
No abstract text is available yet for this article.
March 25, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29572808/readmission-and-complications-within-30-days-after-intrathecal-baclofen-pump-placement
#6
Sandi K Lam, Rory R Mayer, Aditya Vedantam, Kristen A Staggers, Dominic A Harris, I-Wen Pan
AIM: To describe 30-day outcomes after intrathecal baclofen (ITB) pump placement in children and identify risk factors for readmission, reoperation, and perioperative complication using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. METHOD: Patients aged 0 to 18 years who underwent ITB pump placement (2012-2014) comprised the study cohort defined in the database. Multivariate regression analysis was performed using preoperative and perioperative data from the American College of Surgeons' NSQIP-P database...
March 23, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29570548/intrathecal-baclofen-therapy-prior-to-spinal-fusion-for-patients-with-gross-motor-function-classification-system-iv-v-cerebral-palsy
#7
Kristin Buxton, Rachel Difazio, Ann Morgan, Margaret McCabe, Peter W Forbes
BACKGROUND: Patients with Gross Motor Function Classification System (GMFCS) IV-V cerebral palsy (CP) have significant spasticity and frequently develop scoliosis. Intrathecal baclofen (ITB) pumps are effective in managing spasticity. The effect of ITB therapy on the postoperative course following spinal fusion in patients with GMFCS IV-V CP has not been described. This study sought to compare postoperative recovery, including complications, in patients using ITB therapy with those with no ITB therapy...
March 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29532593/case-series-intrathecal-baclofen-therapy-in-stiff-person-syndrome
#8
Justin Ralph Abbatemarco, Mary Alissa Willis, Robert G Wilson, Sean J Nagel, Andre G Machado, Francois A Bethoux
OBJECTIVES: Stiff-person syndrome (SPS) is associated with axial rigidity superimposed on sustained muscle spasms. These symptoms commonly interfere with the performance of activities of daily living including ambulation. This retrospective case series evaluates the outcomes of screening tests and chronic infusion of intrathecal baclofen (ITB) in patients diagnosed with SPS treated in our spasticity clinic. MATERIALS AND METHODS: Patients were identified from an institutional review board-approved clinical registry of ITB therapy...
March 13, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29521737/an-unreported-cause-of-intrathecal-baclofen-withdrawal-symptoms-in-a-woman-with-spastic-cerebral-palsy-who-received-intrathecal-gablofen
#9
Sylvia A Duraski, Anjum Sayyad
This article details an unreported potential cause of withdrawal symptoms in a patient with cerebral palsy who experienced intrathecal baclofen withdrawal shortly after placement of a baclofen pump with subsequent refill with Gablofen. Initial implantation of the baclofen pump with Lioresal occurred after a successful hospital trial of intrathecal injection via lumbar puncture. However, later, the patient did experience signs and symptoms of baclofen withdrawal after a pump refill was performed with Gablofen...
April 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29492826/treatment-of-complex-regional-pain-syndrome-an-updated-systematic-review-and-narrative-synthesis
#10
Silvia Duong, Daniela Bravo, Keith J Todd, Roderick J Finlayson, De Q Tran
PURPOSE: Although multiple treatments have been advocated for complex regional pain syndrome (CRPS), the levels of supportive evidence are variable and sometimes limited. The purpose of this updated review is to provide a critical analysis of the evidence pertaining to the treatment of CRPS derived from recent randomized-controlled trials (RCTs). SOURCE: The MEDLINE, EMBASE, Psychinfo, and CINAHL databases were searched to identify relevant RCTs conducted on human subjects and published in English between 1 May 2009 and 24 August 2017...
February 28, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29478715/validated-chromatographic-method-for-the-simultaneous-determination-of-eight-drugs-morphine-ropivacaine-bupivacaine-baclofen-clonidine-sufentanil-fentanyl-and-ziconotide-for-intrathecal-analgesia
#11
J Sorrieul, J Robert, V Gibory, M Collet, M Boutet, H Kieffer, C Folliard, D Dupoiron, C Devys
Intrathecal analgesia has increased over the past two decades in various indications: chronic refractory pain from cancerous or non-cancerous origins, spasticity. These different indications involve the use of different molecules alone or in combination such as morphine, ropivacaine, bupivacaine, fentanyl, sufentanil, clonidine, baclofen and ziconotide. Pump refills are prepared at the pharmacy under a laminar flow hood. An analytical control should be carried out before release of the preparation. A new method of analytical control by chromatography has been developed and validated according to the International Conference on Harmonization guideline in order to secure the production process...
May 2018: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/29405267/pharmacological-and-neurosurgical-interventions-for-managing-dystonia-in-cerebral-palsy-a-systematic-review
#12
REVIEW
Darcy Fehlings, Leah Brown, Adrienne Harvey, Kate Himmelmann, Jean-Pierre Lin, Alexander Macintosh, Jonathan W Mink, Elegast Monbaliu, James Rice, Jessica Silver, Lauren Switzer, Ilana Walters
AIM: To systematically review evidence for pharmacological/neurosurgical interventions for managing dystonia in individuals with cerebral palsy (CP) to inform a care pathway. METHOD: Searches included studies with a minimum of five participants with dystonia in CP receiving oral baclofen, benzodiazepines (clonazepam, diazepam, lorazepam), clonidine, gabapentin, levodopa, trihexyphenidyl, botulinum toxin, intrathecal baclofen (ITB), or deep brain stimulation (DBS)...
April 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29372855/placement-of-baclofen-pump-catheter-through-a-c1-2-puncture-technical-note
#13
Zaid Aljuboori, Jacob Archer, Wei Huff, Amee Moreno, Andrew Jea
Intrathecal baclofen has been suggested as an effective and safe treatment for intractable spasticity and dystonia. Techniques of lumbar and intraventricular catheter placement have been previously described. The purpose of this study was to describe a technique to implant catheters for intrathecal baclofen infusion through C1-2 puncture. Four of 5 consecutively treated patients underwent successful placement of catheters for intrathecal baclofen. There were no instances of infection, CSF leak, or catheter migration seen during a follow-up period of at least 6 months; furthermore, there were no occurrences of vertebral artery or spinal cord injury...
April 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29372853/a-standardized-protocol-to-reduce-pediatric-baclofen-pump-infections-a-quality-improvement-initiative
#14
Virendra R Desai, Jeffrey S Raskin, Arvind Mohan, JoWinsyl Montojo, Valentina Briceño, Daniel J Curry, Sandi Lam
OBJECTIVE Intrathecal baclofen pumps are generally placed in children for the treatment of spasticity and dystonia. Use of implants in this pediatric population with comorbidities is reported to have a high risk of complications and infections. With the aim of reducing baclofen pump-related infections, a quality improvement project was instituted at the authors' institution. METHODS A workflow paradigm unique to baclofen pump implantation aimed at decreasing implant-related infections was implemented. All baclofen pump operations performed at the authors' institution between August 2012 and June 2016 were reviewed...
April 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29366919/treatment-of-postanoxic-action-myoclonus-with-intrathecal-baclofen-a-case-report
#15
James A Whitlock, Ryan W Dumigan
A case of severe action myoclonus after pulmonary arrest is described. Although there was benefit from oral pharmacotherapy, action myoclonus remained disabling. A favorable response to baclofen during an intrathecal trial led to eventual placement of an intrathecal baclofen pump. The present case illustrates the potential utility of intrathecal baclofen for treating this condition. LEVEL OF EVIDENCE: To be determined.
January 31, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29355915/how-to-assess-goals-in-intrathecal-baclofen-therapy
#16
Laura A Bonouvrié
No abstract text is available yet for this article.
April 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29351050/hidden-medical-devices-in-the-school-setting-what-the-school-nurse-needs-to-know-about-the-safe-use-of-baclofen-pumps
#17
Barbara Obst, Megan Roesler
One of the "hidden" medical devices in the school setting is the baclofen pump, which is used for the treatment of spasticity. The goals of spasticity treatment are to decrease muscle tone, deformity, and pain in order to maximize function and ease of care for both child and caregiver. The use of an intrathecal baclofen pump, often for children with cerebral palsy, spinal cord injury, brain injury, or stroke, has been effective in spasticity treatment. It is important for school nurses to be aware of the safety implications associated with this type of device...
March 2018: NASN School Nurse
https://www.readbyqxmd.com/read/29349778/intrathecal-baclofen-therapy-in-children-an-analysis-of-individualized-goals
#18
Peck Yee Liew, Kirsty Stewart, Debra Khan, Sarah Jane Arnup, Adam Scheinberg
AIM: To determine whether intrathecal baclofen (ITB) therapy improves performance and performance satisfaction in goal areas identified by patients' parents. METHOD: This study formed part of an ongoing multicentre national audit involving six paediatric ITB pump implant centres across Australia. The Canadian Occupational Performance Measure was the primary outcome measure utilized at baseline, 6 months, and 12 months after pump implants in paediatric patients receiving ITB therapy for the first time between 31st December 2009 and 31st December 2014...
April 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29330080/use-of-pulsed-radiofrequency-energy-device-peak-plasmablade-in-neuromodulation-implant-revisions
#19
Ismail Ughratdar, Khandkar Ali Kawsar, Rosalind Mitchell, Richard Selway, Keyoumars 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, Minneapolis, Minnesota, USA), which facilitates dissection around implants without the risk of damaging or transmitting energy through the system...
April 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
#20
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
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