gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Long-term intrathecal Baclofen treatment in cerebral spasticity

Meeting Abstract

Suche in Medline nach

  • A. Koulousakis - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität zu Köln, Köln, Deutschland
  • corresponding author D. Weiss - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität zu Köln, Köln, Deutschland
  • M. Weber - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität zu Köln, Köln, Deutschland
  • D. Lenartz - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität zu Köln, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP037

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0305.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Koulousakis et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Despite the fact that there is no doubt for the effectiveness of intrathecal (IT) Baclofen application with regards to the treatment of spinal spasticity, it took a long time until this method was approved for the treatment of cerebral spasticity. Based on our experience of 18 years with IT Baclofen therapy, we would like to comment on three important points, namely the efficiency – especially the improvement in motor function, care and physiotherapy – and the tolerance as well the safety of this method.

Methods

From August 1986 to May 2002, 360 patients were treated with the intrathecal Baclofen therapy in our department, a third of the latter for cases of cerebral spasticity. 57 of the 107 patients with cerebral spasticity, which continue their treatment in our clinic, were registered in August. This group consist of 31 female and 26 male patients ranging from 11 to 79 years, the average being 42 years. There are 12 patients with Cerebral Palsy (CP), 12 patients with brain injury, 16 patients with hypoxia, 16 patients with intracranial bleeding and one with an intracranial tumour.

Results

We registered a significant reduction in tone. The Ashworth scale went down from a score of 5 preoperative to 2.6 postoperative. On the whole, the percentage of technical complications like catheter dislocation or break/ pump malfunction is under 10 % and thus very low. The same applies to the medical complications. Serious neurological deficits were neither observed following bolus administration nor following continuous administration. Development of a tolerance could be observed by only very few of our patients in a follow-up reaching back 16 years. After dosage adjustment, these results remained consistent over the same time span.

Conclusions

The IT-Baclofen therapy is a safe and successful method of treating constant severe cerebral spasticity. Subsequent examinations up to 16 years showed a constant efficacy and almost no development of tolerance. Care and physiotherapy can be improved so that patients get a distinct improvement in their quality of life.