Francisco G E
Physical Medicine and Rehabilitation, University of Texas Health Sciences Center, Houston, TX, USA.
Eura Medicophys. 2004 Jun;40(2):131-43.
This review article will discuss the application of intrathecal baclofen (ITB) therapy in the upper motor neuron syndrome (UMNS). While the UMNS consists of a variety of signs and symptoms, spasticity appears to be the most widely discussed in research and clinical practice. Thus, while a variety of motor disorders result from spasticity and the other components of the UMNS, such as dystonia, rigidity, and co-contraction of agonists and antagonists, we will refer to spasticity as the representative pathology of the UMNS. The term spasticity will be used in this discussion as if it were synonymous to the UMNS, because it is the term used in most published research and papers. This does not necessarily mean that the other features of the UMNS are less important. Publications in the use of ITB in the pediatric population, especially cerebral palsy, abound, but this paper will focus on UMNS in adults. In addition to reviewing the process of ITB management, from patient selection to rehabilitation, topics of practical interest to clinicians will be discussed.
这篇综述文章将讨论鞘内注射巴氯芬（ITB）疗法在上运动神经元综合征（UMNS）中的应用。虽然UMNS包含多种体征和症状，但在研究和临床实践中，痉挛似乎是讨论最为广泛的。因此，尽管痉挛以及UMNS的其他组成部分（如肌张力障碍、僵硬和主动肌与拮抗肌的共同收缩）会导致多种运动障碍，但我们将痉挛视为UMNS的典型病理表现。在本讨论中，痉挛一词将被用作与UMNS同义，因为它是大多数已发表研究和论文中使用的术语。这并不一定意味着UMNS的其他特征不那么重要。关于ITB在儿科人群（尤其是脑瘫）中应用的出版物很多，但本文将重点关注成人的UMNS。除了回顾ITB治疗的过程，从患者选择到康复，还将讨论临床医生实际感兴趣的话题。
