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Opisthotonus and intrathecal treatment with baclofen (ITB) in children

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Abstract

Opisthotonus is a relatively rare, but challenging neurological symptom of spasticity or dystonia that most often results from a dramatic event such as near-drowning. The classic treatment option for opisthotonus is the oral administration of medication such as benzodiazepines and baclofen. However, results with these medications are usually not very beneficial. Numerous studies however have shown that intrathecal treatment with baclofen (ITB) is an efficient and safe treatment for generalized therapy-resistant spasticity, even in children. In this retrospective study, we describe 11 children (mean age 9 years) with pronounced opisthotonus and quadriplegia caused by different types of acquired lesions who were treated with intrathecal baclofen. Results show that in addition to an expected decrease in muscle tonus, there was also a clear improvement in patient comfort and nursing. A remarkable weight gain was observed in most patients, even when calorie intake did not change. This increase in weight might be due to a reduction in energy expenditure as a result of the decrease in spasticity. Intrathecal treatment with baclofen should be considered in every child with opisthotonus.

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References

  1. Albright AL, Ferson SS (2006) Intrathecal baclofen therapy in children. Neurosurg Focus 21(2):e3

    Article  PubMed  Google Scholar 

  2. Azouvi P, Mane M, Thiebaut JB (1996) Intrathecal baclofen administration for control of severe spinal spasticity: functional improvement and long-term follow-up. Arch Phys Med Rehabil 77:35–39

    Article  PubMed  CAS  Google Scholar 

  3. Bottanelli M, Rubini G, Venturelli V, Cosentino A, Rossato G, Vicentini S et al (2004) Weight and height gain after intrathecal baclofen pump implantation in children with spastic tetraparesis. Dev Med Child Neurol 46:788–789

    Article  PubMed  Google Scholar 

  4. Campbell WM, Ferrel A, McLaughlin JF, Grant GA, Loser JD, Graubert C et al (2002) Long-term safety and efficacy of continuous intrathecal baclofen. Dev Med Child Neurol 44:660–665

    Article  PubMed  Google Scholar 

  5. Diesing TS (2006) Arc de cercle and dysautonomia from anoxic injury. Mov Disord 21(6):868–869

    Article  PubMed  Google Scholar 

  6. Francisco GE, Boake C (2003) Improvement in walking speed in poststroke spastic hemiplegia after intrathecal baclofen therapy: a preliminary study. Arch Phys Med Rehabil 84(8):1194–1199

    Article  PubMed  Google Scholar 

  7. Gerszten PC, Albright AL, Johnstone GF (1998) Intrathecal baclofen infusion and subsequent orthopedic surgery in patients with spastic cerebral palsy. J Neurosurg 88:1009–1013

    Article  PubMed  CAS  Google Scholar 

  8. Hemingway C, McGrogan J, Freeman JM (2001) Energy requirements of spasticity. Dev Med Child Neurol 43:277–278

    Article  PubMed  CAS  Google Scholar 

  9. Kenis S, van Rhijn J, Van Havenberg T, Laridon A, Ceulemans B (2006) Intrathecal baclofen (ITB) therapy for spastic children: 7 years of experience. Neuropediatrics 37(suppl. 1):s17 (Abstract)

    Google Scholar 

  10. McCoy AA, Fox MA, Schaubel DE, Ayyangar RN (2006) Weight gain in children with hypertonia of cerebral origin receiving intrathecal baclofen therapy. Arch Phys Med Rehabil 87(11):1503–1508

    Article  PubMed  Google Scholar 

  11. Stallings VA, Charney EB, Davies JC, Cronck CE (1993) Nutritional status and growth of children with diplegic or hemiplegic cerebral palsy. Dev Med Child Neurol 35:997–1006

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

From Medtronic Belgium, we thank Ben Isebaert and Kathleen Castelein for their long and fine collaboration and Ruben Cornelis for his logistic assistance and statistic support in making this manuscript. The conclusions of this study are made independently from the company.

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Correspondence to Berten Ceulemans.

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Ceulemans, B., van Rhijn, J., Kenis, S. et al. Opisthotonus and intrathecal treatment with baclofen (ITB) in children. Eur J Pediatr 167, 641–645 (2008). https://doi.org/10.1007/s00431-007-0563-3

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  • DOI: https://doi.org/10.1007/s00431-007-0563-3

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