PM&R
Volume 1, Issue 9 , Pages 852-858, September 2009

Intrathecal Baclofen Therapy: An Update

  • Gerard E. Francisco, MD

      Affiliations

    • University of Health Science Center-Houston, the Institute for Rehabilitation and Research, Houston, TX†
    • ,
  • Michael F. Saulino, MD, PhD

      Affiliations

    • MossRehab, Albert Einstein Healthcare Network, Jefferson Medical College, Philadelphia, PA‡
    • Corresponding Author InformationAddress correspondence to M.S.
    • ,
  • Stuart A. Yablon, MD

      Affiliations

    • Methodist Rehabilitation Center, University of Mississippi Medical Center, Jackson, MS§
    • ,
  • Michael Turner, MD

      Affiliations

    • Indianapolis Neurosurgical Group, Indianapolis, IN

Received 14 July 2009; accepted 30 July 2009.

Intrathecal administration of baclofen is a well-established technique for modulating hypertonia secondary to upper motor neuron pathology. Despite the nearly 2 decades of widespread clinical use, this intervention presents many challenges to even experienced clinicians. The purpose of this clinical review is to describe some of the intricacies and subtleties of this treatment strategy. This narrative provides an overview of 3 topics: (1) an alternative methodology for intrathecal baclofen trials; (2) an algorithmic approach to troubleshooting intrathecal delivery systems; and (3) the utility of neurophysiologic assessments within various phases of intrathecal baclofen therapy.

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  • † Disclosure: 2A; Medtronic; 3B Medtronic; 7B, Medtronic, Allergan; 8A
  • ‡ Disclosure: 3A, Medtronic Inc., Elan Pharmaceuticals
  • § Disclosure: 2A, Allergan, Codman Inc., and Merz; 5A; 7B, Medtronic Inc.; 8B, NIDRR
  •  Disclosure: 2B, Medtronic, Solstice; 3B

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

PII: S1934-1482(09)00760-6

doi:10.1016/j.pmrj.2009.07.015

PM&R
Volume 1, Issue 9 , Pages 852-858, September 2009

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