Conçalves J, García-March G, Sánchez-Ledesma M J, Onzaín I, Broseta J
Department of Neurosurgery, University of Salamanca, Spain.
Stereotact Funct Neurosurg. 1994;62(1-4):108-12. doi: 10.1159/000098605.
Today it is accepted that chronic infusion of baclofen produces significant relaxation and drastic reduction of spasms, amelioration of cramping pain and improvement of sphincter functions in spasticity of spinal cord origin. Based on these results our group had the opportunity of treating 11 cases with refractory spasticity and dystonic symptoms due to central damage caused by head injury in 8 cases and to cerebral palsy in 3 using cervical intrathecal infusion of baclofen. During the trial period with percutaneous intrathecal infusion of a daily bolus of 12.5-75 micrograms of baclofen through a reservoir, improvement of mentation and speech conditions, marked improvement of dystonic and abnormal movements of the upper limbs and trunk and a notable reduction of hypertonia were observed in all cases, which led to a better performance of motor activities in skilled acts and transfer. With these preliminary results in mind, in all cases the previous cervical subarachnoid catheter was attached to a programmable pump that infused a daily total dose varying from 100 to 190 micrograms of baclofen in a continuous or multistep complex mode. After a mean follow-up of 21 months previous results were long-lasting. Neither overdose side effects nor malfunction of the system were observed.
如今，人们公认，长期输注巴氯芬可显著放松肌肉并大幅减轻痉挛，缓解痉挛性疼痛，改善脊髓源性痉挛患者的括约肌功能。基于这些结果，我们团队有机会治疗了11例难治性痉挛和肌张力障碍症状患者，其中8例因头部受伤导致中枢损伤，3例因脑瘫，均采用颈段鞘内输注巴氯芬。在经皮鞘内输注试验期，通过储液器每日推注12.5 - 75微克巴氯芬，所有病例均观察到精神状态和言语状况改善，上肢和躯干的肌张力障碍及异常运动明显改善，肌张力显著降低，这使得患者在熟练动作和转移等运动活动中表现更佳。鉴于这些初步结果，所有病例中先前的颈段蛛网膜下腔导管均连接到可编程泵，该泵以连续或多步复合模式每日输注总量为100至190微克的巴氯芬。平均随访21个月后，先前的结果持久有效。未观察到过量副作用或系统故障。
