Continuous intrathecal baclofen infusion for spasticity of cerebral origin.

OBJECTIVE

To determine if continuous intrathecal baclofen infusion (CIBI) would provide continuous relief of spasticity in patients with spasticity of cerebral origin, especially children with cerebral palsy.

DESIGN

Prospective, unblinded trial, before and after CIBI.

SETTING

Children's Hospital of Pittsburgh (Pa).

PATIENTS

Thirty-seven patients, 5 to 27 years of age, with spasticity of cerebral origin.

INTERVENTION

Continuous intrathecal baclofen infusion for 3 to 48 months.

MAIN OUTCOME MEASURES

Muscle tone, range of motion, upper extremity timed tasks, activities of daily living (ADLs).

RESULTS

Six and 12 months after CIBI, muscle tone was significantly decreased in the upper (P = .04) and lower (P = .001) extremities. There was a significant relationship between baclofen dosage and muscle tone in the upper (P = .02) and lower (P = .001) extremities. Hamstring motion, upper extremity function, and ADLs were significantly improved in 25 patients who were capable of self-care.

CONCLUSION

Spasticity of cerebral origin can be effectively treated with CIBI. Because baclofen dosages can be titrated for the desired clinical response, CIBI is particularly useful for patients who need some spasticity to stand and ambulate.