• Spinal cord · Jun 2010

    Tolerance to continuous intrathecal baclofen infusion can be reversed by pulsatile bolus infusion.

    • H W Heetla, M J Staal, and T van Laar.
    • Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. h.w.heetla@neuro.umcg.nl
    • Spinal Cord. 2010 Jun 1; 48 (6): 483-6.

    Study DesignPilot study.ObjectiveTo study the effect of pulsatile bolus infusion of intrathecal baclofen (ITB) on daily ITB dose, in patients showing dose increases, probably due to tolerance.SettingDepartment of neurology and neurosurgery, University Medical Center Groningen, the Netherlands.MethodsData on dosages and clinical efficacy were gathered from four patients who were switched from continuous to pulsatile bolus infusion of ITB, because of the probable diagnosis of tolerance to ITB.ResultsSwitching from continuous to pulsatile bolus infusion resulted in a decrease of the daily ITB dose, while the clinical effect could be kept stable, without introducing adverse events.ConclusionPulsatile bolus infusion of ITB seems to be an effective and safe treatment strategy to reverse the need for increasing ITB dosages in patients with the probable diagnosis of tolerance to ITB.

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