Intrathecal Baclofen Pump
Intrathecal Baclofen Pump:
⦁ Baclofen is a muscle relaxant medicine commonly used to decrease spasticity related to multiple sclerosis, spinal cord injuries, or other neurological diseases. An intrathecal delivery system, which provides the baclofen right to the target site in the spinal cord, is an effective way to deliver the medicine.
What is spasticity?
⦁ Spasticity is a movement disorder that can occur in conditions which affect the brain or the spinal cord, such as multiple sclerosis, stroke, cerebral palsy, spinal cord injury, or brain injury. Spasticity is caused by an imbalance between signals that inhibit or stimulate the spinal cord. This results in hyper excitable stretch reflexes, increased muscle tone, and involuntary movements.
What are the symptoms of spasticity?
⦁ Spasticity causes muscle stiffness and tightness, which interferes with voluntary movements. Spasticity can also cause muscle spasms (jerky involuntary movements) or clonus (repetitive involuntary movement). Stiffness and spasms are often bothersome and sometimes painful, and they interfere with the ability to carry out daily activities. Spasms may also disrupt sleep and increase daytime fatigue. When spasticity is severe, contracture (fixed limitations of range of motion) may develop.
How can spasticity be treated
⦁ Stretching, exercise, and rehabilitation are the first line of interventions for
spasticity. Oral medications are often effective, but may cause side effects such as drowsiness. When spasticity affects only a few muscles, local injections of botulinum toxin can be helpful. When spasticity is diffuse and severe, intrathecal baclofen (Lioresal®) (ITB) may be a good treatment option.
What are the advantages of ITB compared to taking baclofen by mouth
⦁ ITB is usually much more effective in controlling the symptoms of spasticity, because the medication is brought directly in contact with the spinal cord.
⦁ With ITB, the medication is delivered continuously, day and night, giving a more steady relief of symptoms.
⦁ ITB, in most cases, causes less side effects than oral baclofen, particularly when high doses are needed to treat severe spasticity.
⦁ ITB programming is very flexible, allows more precise dosing of baclofen, and gives the ability to deliver different doses at different times of the day.
⦁ Compared to other surgical treatments, ITB is reversible, as the pump can be stopped and removed if needed
What are the potential risks and adverse effects of ITB
⦁ The baclofen pump system needs to be surgically implanted under anesthesia, leading to the usual risks of surgery.
⦁ Complications more specific to ITB include the risk of infection around the device, and the risk of device malfunction.
⦁ Baclofen withdrawal (from abrupt interruption of the delivery of baclofen via the pump) and baclofen overdose (usually as a result of human error) have also occurred with ITB.
⦁ Serious complications from ITB are infrequent, and in most cases reversible as long as they are diagnosed and treated in a timely fashion.