Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1989 Aug;52(8):933–939. doi: 10.1136/jnnp.52.8.933

Intrathecal baclofen for long-term treatment of spasticity: a multi-centre study.

G Ochs 1, A Struppler 1, B A Meyerson 1, B Linderoth 1, J Gybels 1, B P Gardner 1, P Teddy 1, A Jamous 1, P Weinmann 1
PMCID: PMC1031830  PMID: 2487035

Abstract

Twenty eight patients with severe, intractable spasticity have been treated by chronic intrathecal administration of baclofen. An implantable programmable drug-administration-device (DAD) was used with a permanent intrathecal catheter. Infusion of 50 to 800 micrograms/day of baclofen completely abolished spasticity. Follow-up was up to two years. Therapeutic effect was documented by clinical assessment of tone, spasms and reflexes and by electrophysiological recordings of mono- and polysynaptic reflex activity. Complications and untoward side-effects of the procedure were few. This procedure is recommended for spasticity of spinal origin refractory to physiotherapy and oral medication. It is a preferable alternative to ablative surgical intervention.

Full text

PDF
933

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Davidoff R. A. Antispasticity drugs: mechanisms of action. Ann Neurol. 1985 Feb;17(2):107–116. doi: 10.1002/ana.410170202. [DOI] [PubMed] [Google Scholar]
  2. Fromm G. H., Terrence C. F., Chattha A. S. Baclofen in the treatment of trigeminal neuralgia: double-blind study and long-term follow-up. Ann Neurol. 1984 Mar;15(3):240–244. doi: 10.1002/ana.410150306. [DOI] [PubMed] [Google Scholar]
  3. Haas H. L., Greene R. W., Olpe H. R. Stereoselectivity of L-baclofen in hippocampal slices of the rat. Neurosci Lett. 1985 Mar 22;55(1):1–4. doi: 10.1016/0304-3940(85)90302-7. [DOI] [PubMed] [Google Scholar]
  4. Henry J. L. Effects of intravenously administered enantiomers of baclofen on functionally identified units in lumbar dorsal horn of the spinal cat. Neuropharmacology. 1982 Nov;21(11):1073–1083. doi: 10.1016/0028-3908(82)90164-2. [DOI] [PubMed] [Google Scholar]
  5. Howe J. R., Zieglgänsberger W. D-baclofen does not antagonize the actions of L-baclofen on rat neocortical neurons in vitro. Neurosci Lett. 1986 Dec 3;72(1):99–104. doi: 10.1016/0304-3940(86)90626-9. [DOI] [PubMed] [Google Scholar]
  6. Jones R. F., Burke D., Marosszeky J. E., Gillies J. D. A new agent for the control of spasticity. J Neurol Neurosurg Psychiatry. 1970 Aug;33(4):464–468. doi: 10.1136/jnnp.33.4.464. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Knutsson E., Lindblom U., Mårtensson A. Plasma and cerebrospinal fluid levels of baclofen (Lioresal) at optimal therapeutic responses in spastic paresis. J Neurol Sci. 1974 Nov;23(3):473–484. doi: 10.1016/0022-510x(74)90163-4. [DOI] [PubMed] [Google Scholar]
  8. Kroin J. S., Penn R. D., Beissinger R. L., Arzbaecher R. C. Reduced spinal reflexes following intrathecal baclofen in the rabbit. Exp Brain Res. 1984;54(1):191–194. doi: 10.1007/BF00235831. [DOI] [PubMed] [Google Scholar]
  9. McLellan D. L., Selwyn M., Cooper I. S. Time course of clinical and physiological effects of stimulation of the cerebellar surface in patients with spasticity. J Neurol Neurosurg Psychiatry. 1978 Feb;41(2):150–160. doi: 10.1136/jnnp.41.2.150. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Müller H., Zierski J., Dralle D., Börner U., Hoffmann O. The effect of intrathecal baclofen on electrical muscle activity in spasticity. J Neurol. 1987 Jun;234(5):348–352. doi: 10.1007/BF00314294. [DOI] [PubMed] [Google Scholar]
  11. Pedersen E., Petersen T., Schrøder H. D. Relation between flexor spasms, uninhibited detrusor contractions and anal sphincter activity. J Neurol Neurosurg Psychiatry. 1986 Mar;49(3):273–277. doi: 10.1136/jnnp.49.3.273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Penn R. D., Kroin J. S. Continuous intrathecal baclofen for severe spasticity. Lancet. 1985 Jul 20;2(8447):125–127. doi: 10.1016/s0140-6736(85)90228-4. [DOI] [PubMed] [Google Scholar]
  13. Penn R. D., Kroin J. S. Intrathecal baclofen alleviates spinal cord spasticity. Lancet. 1984 May 12;1(8385):1078–1078. doi: 10.1016/s0140-6736(84)91487-9. [DOI] [PubMed] [Google Scholar]
  14. Penn R. D., Paice J. A. Chronic intrathecal morphine for intractable pain. J Neurosurg. 1987 Aug;67(2):182–186. doi: 10.3171/jns.1987.67.2.0182. [DOI] [PubMed] [Google Scholar]
  15. Rawal N., Arnér S., Gustafsson L. L., Allvin R. Present state of extradural and intrathecal opioid analgesia in Sweden. A nationwide follow-up survey. Br J Anaesth. 1987 Jun;59(6):791–799. doi: 10.1093/bja/59.6.791. [DOI] [PubMed] [Google Scholar]
  16. Sawynok J., Dickson C. D-Baclofen is an antagonist at baclofen receptors mediating antinociception in the spinal cord. Pharmacology. 1985;31(5):248–259. doi: 10.1159/000138129. [DOI] [PubMed] [Google Scholar]
  17. Sindou M., Abdennebi B., Sharkey P. Microsurgical selective procedures in peripheral nerves and the posterior root-spinal cord junction for spasticity. Appl Neurophysiol. 1985;48(1-6):97–104. doi: 10.1159/000101110. [DOI] [PubMed] [Google Scholar]
  18. Steardo L., Leo A., Marano E. Efficacy of baclofen in trigeminal neuralgia and some other painful conditions. A clinical trial. Eur Neurol. 1984;23(1):51–55. doi: 10.1159/000115677. [DOI] [PubMed] [Google Scholar]
  19. Struppler A., Burgmayer B., Ochs G. B., Pfeiffer H. G. The effect of epidural application of opioids on spasticity of spinal origin. Life Sci. 1983;33 (Suppl 1):607–610. doi: 10.1016/0024-3205(83)90576-3. [DOI] [PubMed] [Google Scholar]
  20. Wilson P. R., Yaksh T. L. Baclofen is antinociceptive in the spinal intrathecal space of animals. Eur J Pharmacol. 1978 Oct 15;51(4):323–330. doi: 10.1016/0014-2999(78)90423-5. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES