Saltuari L, Kronenberg M, Marosi M J, Kofler M, Russegger L, Rifici C, Bramanti P, Gerstenbrand F
Department of Neurology, University Hospital, Innsbruck, Austria.
Acta Neurol (Napoli). 1992 Jun;14(3):195-207.
Baclofen, a derivate of gamma-amino butyric acid (GABA), is known to be a useful drug in spasticity treatment. To achieve a good therapeutic response higher oral dosages have to be administered related with central side effects. Intrathecal application of Baclofen in microgram range dosages is proved to be effective in spinal spasticity. The efficiency of intrathecal Baclofen in patients suffering from supraspinal spasticity is discussed controversially. We report on 9 patients with long-term intrathecal Baclofen treatment, all of them responding well presenting a marked reduced muscle tone. In most cases an improvement of motor performance and in two cases improved bladder function was observed. The therapeutical dosages administered to patients with supraspinal spasticity exceed those administered to patients with spinal spasticity by approximately 100% without provoking central side effects. Despite the risks connected with this method it has to be considered as treatment of choice in cases of severe supraspinal spasticity.
巴氯芬是γ-氨基丁酸（GABA）的衍生物，已知是治疗痉挛的一种有效药物。为了获得良好的治疗反应，必须给予较高的口服剂量，但这会带来中枢副作用。鞘内注射微克级剂量的巴氯芬已被证明对脊髓性痉挛有效。鞘内注射巴氯芬对患有脊髓上痉挛的患者的疗效存在争议。我们报告了9例长期接受鞘内巴氯芬治疗的患者，他们均反应良好，肌张力明显降低。在大多数情况下，运动能力得到改善，在两例患者中观察到膀胱功能改善。给予脊髓上痉挛患者的治疗剂量比给予脊髓性痉挛患者的剂量高出约100%，且未引发中枢副作用。尽管这种方法存在风险，但在严重脊髓上痉挛的情况下，它仍应被视为首选治疗方法。
