Clinical application of drug pump for spasticity, pain, and restorative neurosurgery: other clinical applications of intrathecal baclofen

  • Takaomi Taira
  • T. Hori
Conference paper
Part of the Acta Neurochirurgica Supplements book series (NEUROCHIRURGICA, volume 87)


Intrathecal baclofen has been successfully used for control of severe spasticity. Baclofen, an agonist of GABA-B receptor, has other potential effects on pain and recovery from coma. 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 involves in spinal GABAergic system. The GABAergic system in the spinal cord plays a pivotal role in various clinical effects of these procedures.


Baclofen pain dystonia 


  1. 1.
    Albright AL, Barry MJ, Shafton DH, Ferson SS (2001) Intrathecal baclofen for generalized dystonia. Dev Med Child Neurol 43: 652–657PubMedCrossRefGoogle Scholar
  2. 2.
    Cui JG et al (1996) Effects of spinal cord stimulation on touchevoked allodynia involve GABAergic mechanisms. Pain 66: 287–295PubMedCrossRefGoogle Scholar
  3. 3.
    Herman RM, D’Luzansky SD, Ippolito R (1992) Intrathecal baclofen suppresses central pain in patients with spinal lesions. Clin J Pain 8: 338–345PubMedCrossRefGoogle Scholar
  4. 4.
    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: 367–375PubMedCrossRefGoogle Scholar
  5. 5.
    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: 381–386PubMedCrossRefGoogle Scholar
  6. 6.
    Taira T, Kawamura H, Tanikawa T et al (1995) A new approach to the control of central deafferentation pain. Acta Neurochir (Wien) 64: 136–138CrossRefGoogle Scholar
  7. 7.
    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: 127–134Google Scholar
  8. 8.
    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 201–204Google Scholar
  9. 9.
    van Hilten BJ, van de Beek WJ, HofT JI, Voormolen JH, Delhaas EM (2000) Intrathecal baclofen for the treatment of dystonia in patients with reflex sympathetic dystrophy. N Engl J Med 343: 625–630PubMedCrossRefGoogle Scholar
  10. 10.
    Waltz JM, Davis JA (1983) Cervical cord stimulation in the treatment of athetosis and dystonia. Adv Neurol 37: 225–237PubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2003

Authors and Affiliations

  1. 1.Department of Neurosurgery, Neurological InstituteTokyo Women’s Medical UniversityTokyoJapan

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