鞘内注射巴氯芬使一名继发性肌张力障碍患者无需使用膀胱刺激器：病例说明
Intrathecal baclofen obviating the need for bladder stimulator use in a patient with secondary dystonia: illustrative case.
作者信息
Wang Ryan K, Jane Horak Victoria, Abdelmageed Sunny, LoPresti Melissa A, Shahin Maryam N, Katholi Benjamin, Raskin Jeffrey S
机构信息
Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois.
Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois.
出版信息
J Neurosurg Case Lessons. 2024 Oct 14;8(16). doi: 10.3171/CASE24364.
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.
背景
脑瘫患儿常伴有神经源性膀胱。膀胱功能会因复杂的医疗管理和多因素疾病过程而进一步受到影响，导致功能恶化和生活质量下降。鞘内注射巴氯芬（ITB）疗法已被用于治疗张力亢进和痉挛，但在神经源性膀胱管理中的作用尚未得到充分描述。
观察结果
一名有脑瘫和神经源性膀胱病史的20岁女性接受了骶神经调节治疗，随后接受了ITB治疗，膀胱控制能力得到改善，不再需要使用膀胱刺激器。
经验教训
ITB可改善张力亢进，并能有效避免对脑瘫患者使用神经刺激来治疗神经源性膀胱。需要进一步研究以明确其机制。https://thejns.org/doi/10.3171/CASE24364
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