• Konstantinos Margetis, Stefanos I Korfias, Stylianos Gatzonis, Nick Boutos, George Stranjalis, Efstathios Boviatsis, and Damianos E Sakas.
• 1st Department of Neurosurgery, University of Athens, Athens, Greece.
• Neuromodulation. 2014 Oct 1;17(7):699-704: discussion 704.

ObjectiveIntrathecal baclofen (ITB) pump is a therapeutic option for persistent vegetative state and minimal conscious state patients that have associated spasticity. We investigated whether this treatment modality can affect their level of consciousness.MethodIn this prospective, open label, observational study, we implanted ITB pumps for the treatment of spasticity in eight patients with disorders of consciousness (vegetative state and minimally conscious state) and we followed them with the Coma Recovery Scale-Revised, the Eastern Cooperative Oncology Group (ECOG) performance scale, and the Modified Ashworth spasticity scale. Baclofen dose and complications also were noted.ResultsThe offending pathologies were traumatic brain injury in six, anoxia due to cardiac arrest in one, acute obstructive hydrocephalus in one. Two of the patients showed a marked, persistent improvement that fulfilled the criteria of emergence from minimally conscious state. Two of patients had their ITB pumps prematurely removed because of complications. The ECOG score was 4 for all patients and did not change during the study.ConclusionITB might be associated with a significant improvement in the disorder of consciousness of two patients from a total of six that had a chronic ITB treatment.© 2013 International Neuromodulation Society.

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