鞘内巴氯芬治疗神经纤维瘤病相关脊髓损伤伴痉挛--病例报告。

Carl O'Brien, Jacqui Stowe, Michael O'Connor, Jacinta Morgan, Paul Murphy, Darren Roddy, Kirk Levins
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引用次数: 0

摘要

本病例是一名 35 岁男性患者,患有脊柱占位性神经纤维瘤病-1(spinal predominant neurofibromatosis-1),出现了不完全脊髓损伤(C3 Asia C),尽管对多发性颈椎神经纤维瘤进行了紧急减压手术,但病情仍不见好转。本报告概述了鞘内注射巴氯芬的新适应症。患者下肢无力并伴有严重痉挛,所有活动至少需要两人协助。康复治疗的目的是改善患者的整体肌张力,同时注重患者的独立性、活动能力和生活质量。在成功试用了鞘内巴氯芬后,他接受了鞘内巴氯芬泵植入手术。在他接受渐进式伸展和功能康复治疗的同时,剂量也在逐渐增加。6 周后,他的 MAS 已提高到 1-2/4,并已能独立转移、独立进行大多数日常生活活动,而且只需极少的支持就能出院回家。
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INTRATHECAL BACLOFEN FOR NEUROFIBROMATOSIS RELATED SPINAL CORD INJURY WITH SPASTICITY - A CASE REPORT.

This case presents a 35-year-old male with spinal predominant neurofibromatosis-1 who developed an incomplete spinal cord injury (C3 Asia C) which did not improve despite urgent decompressive surgery for multiple cervical neurofibromas. This report outlines a novel indication for intrathecal baclofen. The patient suffered from lower limb weakness with severe spasticity and required assistance of at least two for all activities. The aim of rehabilitation was to improve overall tone while focusing on independence, mobility and quality of life. After a successful trial of intrathecal baclofen, he underwent implantation of an intrathecal baclofen pump. The dose was gradually increased while he received a progressive programme of stretching and functional rehabilitation therapy. After 6 weeks, his MAS had improved to 1-2/4 and he had progressed to independent transfers, independence for most activities of daily living and was able to discharge to his family home with minimal support.

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