Summary
Intrathecal baclofen administration is a fully established treatment for severe spasticity. However, it is scarcely known that Baclofen, an agonist of GABA-B receptor, has other potential effects on pain, restoration coma, dystonia, tetanus, and hypothalamic storm. Sporadic episodes of dramatic recovery from persistent vegetative state are reported after intrathecal administration of baclofen. There are also reports on the use of baclofen for neuropathic pain including poststroke central pain syndrome. Baclofen is also used for control of dystonia due to cerebral palsy or reflex sympathetic dystrophy. On the other hand, epidural spinal cord stimulation has been used for pain, spasticity, dystonia, or attempt to improve deteriorated consciousness, though the effects seem variable and modest. Similarity between baclofen and spinal cord stimulation is interesting in that both involve the spinal GABAergic system. Based on the 15-year personal experience of intrathecal baclofen, I would stress importance of this treatment not only for spasticity but also for other difficult neurological disorders.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Albright AL, Barry MJ, Shafton DH, Ferson SS (2001) Intrathecal baclofen for generalized dystonia. Dev Med Child Neurol 43: 652–657
Cui JG et al (1996) Effects of spinal cord stimulation on touch evoked allodynia involve GABAergic mechanisms. Pain 66: 287–295
Herman RM, D’Luzansky SD, Ippolito R (1992) Intrathecal baclofen suppresses central pain in patients with spinal lesions. Clin J Pain 8: 338–345
Stiller CO et al (1996) Release of GABA in the dorsal horn and suppression of tactile allodynia by spinal cord stimulation in neuropathic rats. Neurosurgery 39: 367–375
Taira T, Kawamura H, Tanikawa T, Iseki H, Takakura K (1994) Spinal intrathecal baclofen suppresses central pain after a stroke. J Neurol Neurosurg Psychiatr 57: 381–386
Taira T, Kawamura H, Tanikawa T et al (1995) A new approach to the control of central deafferentation pain. Acta Neurochir (Wien) 64: 136–138
Taira T, Kawamura H, Tanikawa T et al (1997) Dramatic recovery of consciousness after spinal intrathecal administration of baclofen in patients with severe head injury. Treatment Coma 5: 127–134
Taira T, Hori T (2000) The contemporary role of neurosurgeons in the management of intractable pain. In: Yanagida H et al (eds) Management of pain, a world perspective. Monduzzi, pp 201–204
van Hilten BJ, van de Beek WJ, Ho JI, Voormolen JH, Delhaas EM (2000) Intrathecal baclofen for the treatment of dystonia in patients with reflex sympathetic dystrophy. N Engl J Med 343: 625–630
Waltz JM, Davis JA (1983) Cervical cord stimulation in the treatment of athetosis and dystonia. Adv Neurol 37: 225–237
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2006 Springer-Verlag
About this chapter
Cite this chapter
Taira, T., Ochiai, T., Goto, S., Hori, T. (2006). Fifteen year experience of intrathecal baclofen treatment in Japan. In: Chang, J.W., Katayama, Y., Yamamoto, T. (eds) Advances in Functional and Reparative Neurosurgery. Acta Neurochirurgica Supplementum, vol 99. Springer, Vienna. https://doi.org/10.1007/978-3-211-35205-2_12
Download citation
DOI: https://doi.org/10.1007/978-3-211-35205-2_12
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-35204-5
Online ISBN: 978-3-211-35205-2
eBook Packages: MedicineMedicine (R0)