Intrathecal baclofen obviating the need for bladder stimulator use in a patient with secondary dystonia: illustrative case.

Journal of neurosurgery. Case lessons Pub Date : 2024-10-14 DOI:10.3171/CASE24364

Ryan K Wang, Victoria Jane Horak, Sunny Abdelmageed, Melissa A LoPresti, Maryam N Shahin, Benjamin Katholi, Jeffrey S Raskin

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Abstract

Background: Children with cerebral palsy often have neurogenic bladders. Bladder function is further affected by complex medical management and multifactorial disease processes, leading to worsened function and poorer quality of life. Intrathecal baclofen (ITB) therapy has been used to treat hypertonia and spasticity, but implications in neurogenic bladder management have not been well described.

Observations: A 20-year-old female with a history of cerebral palsy and neurogenic bladder treated with sacral neuromodulation underwent ITB therapy and subsequently experienced improvement in bladder control, obviating the need for bladder stimulator use.

Lessons: ITB improves hypertonia and can effectively obviate the need for neurostimulation to treat neurogenic bladder in patients with cerebral palsy. Further research is necessary to discern mechanisms. https://thejns.org/doi/10.3171/CASE24364.

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继发性肌张力障碍患者无需使用膀胱刺激器的鞘内巴氯芬：说明性病例。

背景：脑瘫患儿通常有神经源性膀胱。复杂的医疗管理和多因素疾病过程会进一步影响膀胱功能，导致功能恶化和生活质量下降。鞘内巴氯芬（ITB）疗法已被用于治疗肌张力亢进和痉挛，但对神经源性膀胱治疗的影响还没有很好的描述：一名 20 岁的女性患者曾患有脑性麻痹和神经源性膀胱，曾接受过骶神经调节治疗，接受 ITB 治疗后，她的膀胱控制能力得到改善，无需再使用膀胱刺激器：启示：ITB 可改善脑性瘫痪患者的张力过高症状，并能有效避免使用神经刺激治疗神经源性膀胱。https://thejns.org/doi/10.3171/CASE24364。

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Journal of neurosurgery. Case lessons

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0.40

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