• Acta Neurochir. Suppl. · Jan 2007

    Review

    Efficacy of intrathecal baclofen delivery in the management of severe spasticity in upper motor neuron syndrome.

    • J S Rietman and J H B Geertzen.
    • Roessingh Research and Development, Enschede, The Netherlands. j.s.rietman@planet.nl
    • Acta Neurochir. Suppl. 2007 Jan 1;97(Pt 1):205-11.

    AbstractIn the treatment of patients with severe spasticity, intrathecal administration of baclofen (ITB) was introduced in order to exert its effect directly at the receptor sites in the spinal cord, and have better therapeutic efficacy with smaller drug doses compared to oral antispasmodic medications. Apart from our own research in Groningen, a review is performed to present and discuss the efficacy of ITB in patients with spasticity and hypertonia as symptoms of the upper motor neuron syndromes. The majority of the ITB studies describe proven efficacy in the reduction of spasticity and spasms in short-term and long-term follow-up. Functional improvements in daily care, hygiene, pain, etc are described but not often with reliable and validated instruments. A few studies reported significant improvement in walking performance in ambulant patients. The studies that have been done on the efficacy of ITB in relation to quality of life (QOL) showed some evidence of improvement. Future research is needed on fine tuning in the ITB therapy using functional assessment instruments.

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