[Intrathecal baclofen in treatment of spasticity casuistry of the Centro Hospitalar de Coimbra]

Abstract

Introduction: The neuromotor techniques do not have good results in severe spasticity prevention and treatment (Ashworth Scale > or = 3). High doses of oral Baclofen are required, thus intrathecal baclofen is a current alternative.

Objectives: To assess the effectiveness of treatment, the eight Spinal Cord Injury (SCI) patients with a intrathecal baclofen pump are controlled in a specific consultation in the Rehabilitation Service of C.H.C. The authors analyse the results and made a bibliographic review.

Methods: Medline research and retrospective study through the analysis of the individual clinical file.

Results: Intrathecal baclofen is effective in severe spasticity when oral baclofen is ineffective or when intolerable side effects occur. In our study group of nine patients, one had infection to the material in the Baclofen pump, and in the other eight patients was observed improvement of spasticity: six were re-classified grade 2 and two were re-classified grade 3 (Modified Ashworth Scale).

Conclusion: Intrathecal baclofen infusion is an effective therapeutic alternative in severe spasticity due to spinal cord lesions. With this method, adequate liquor concentrations for hyperactivity/hipertonicity reduction are possible without the normal side effects that occur with the high oral dosage (about 100 times higher).