Intrathecal Baclofen Infusion: A Treatment for Spasticity and Secondary Generalized Dystonia

Abstract

cant medical problems that effect various patient populations. Systemic medical treatments include baclofen and other medications such as tizanadine and benzodiazepines. Many of these medications cross the blood-brain barrier poorly, only producing a low concentration of drug in the central nervous system. Due to systemic side effects, and the diffi culty achieving blood levels suffi cient to satisfactorily treat spasticity and generalized dystonia, it is often necessary to employ subcutaneous pumps and spinal catheters that allow intrathecal dosing of baclofen. Intrathecal baclofen therapy can be very efficacious for properly selected patients, but there are signifi cant risks that the practitioner and the patient must bear in mind; these include infection, wound breakdown, catheter malfunction, and adverse medication events. As with any surgical treatment, patient selection and appropriate surgical technique are crucial if one is to maximize the benefi ts of therapy and minimize complications. With appropriate patient selection and surgical technique, intrathecal baclofen therapy is a rewarding endeavor that signifi cantly improves patient and caregiver quality of life.