鞘内注射巴氯芬长期治疗结束后，严重痉挛状态持续缓解。
Lasting reduction of severe spasticity after ending chronic treatment with intrathecal baclofen.
作者信息
Dressnandt J, Conrad B
机构信息
Neurologische Klinik, Technische Universität München, Germany.
出版信息
J Neurol Neurosurg Psychiatry. 1996 Feb;60(2):168-73. doi: 10.1136/jnnp.60.2.168.
OBJECTIVE
To investigate whether the dose of intrathecal baclofen necessary for a sufficient reduction of muscle tone and spasms changes during treatment of severe spasticity.
METHODS
A group of 27 patients received intrathecal baclofen for 61 (SD 18) months.
RESULTS
Spasticity remained absent or strongly reduced after stopping the intrathecal baclofen infusion in seven patients. The dose of baclofen could be reduced to 40% of that dose which was originally necessary in 10 patients. The dose remained the same or increased slightly in 10 patients. Possible reasons for the continuing reduction of spasticity after terminating long term intrathecal baclofen infusion in some patients could be: lasting morphological changes in spinal cord neurons by second messenger controlled modulation of gene expression, a toxic effect of baclofen on spinal neurons, muscular atrophy, inflammation due to the catheter, or progression of multiple sclerosis.
CONCLUSIONS
A higher initial daily dose of intrathecal baclofen might lead to a faster, lasting suppression of spasticity and the development of spastic symptoms might even be prevented by pre-emptive treatment with baclofen in patients with newly acquired lesions of the spinal cord.
目的
探讨在严重痉挛治疗过程中，充分降低肌张力和痉挛所需的鞘内注射巴氯芬剂量是否会发生变化。
方法
一组27例患者接受鞘内注射巴氯芬治疗61（标准差18）个月。
结果
7例患者停止鞘内注射巴氯芬后，痉挛仍未出现或明显减轻。10例患者的巴氯芬剂量可降至最初所需剂量的40%。10例患者的剂量保持不变或略有增加。部分患者长期鞘内注射巴氯芬终止后痉挛持续减轻的可能原因有：脊髓神经元通过第二信使控制的基因表达调节发生持久的形态学改变、巴氯芬对脊髓神经元的毒性作用、肌肉萎缩、导管引起的炎症或多发性硬化症的进展。
结论
较高的鞘内注射巴氯芬初始日剂量可能会更快、更持久地抑制痉挛，对于新发生脊髓损伤的患者，预先使用巴氯芬治疗甚至可能预防痉挛症状的出现。
Zotero 插件