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Efficacy of intrathecal baclofen delivery in the management of severe spasticity in upper motor neuron syndrome

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Operative Neuromodulation

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 97/1))

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Summary

In the treatment of patients with severe spasticity, intrathecal administration of baclofen (ITB) was introduced in order to exert its effect directly at the receptor sites in the spinal cord, and have better therapeutic efficacy with smaller drug doses compared to oral antispasmodic medications. Apart from our own research in Groningen, a review is performed to present and discuss the efficacy of ITB in patients with spasticity and hypertonia as symptoms of the upper motor neuron syndromes. The majority of the ITB studies describe proven efficacy in the reduction of spasticity and spasms in short-term and long-term followup. Functional improvements in daily care, hygiene, pain, etc are described but not often with reliable and validated instruments. A few studies reported significant improvement in walking performance in ambulant patients. The studies that have been done on the efficacy of ITB in relation to quality of life (QOL) showed some evidence of improvement. Future research is needed on fine tuning in the ITB therapy using functional assessment instruments.

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Author information

Authors and Affiliations

  1. Roessingh Research and Development, Roessinghsbleekweg 33 B, NL-7522 AH, Enschede, The Netherlands

    Johan S. Rietman

  2. Roessingh Rehabilitation Center, Enschede, The Netherlands

    Johan S. Rietman

  3. University of Twente, Enschede, The Netherlands

    Johan S. Rietman

  4. Center for Rehabilitation, University Medical Center Groningen, University Groningen, Groningen, The Netherlands

    J. H. B. Geertzen

  5. Northern Centre for Health Care Research, University Groningen, Groningen, The Netherlands

    J. H. B. Geertzen

Authors
  1. Johan S. Rietman
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  2. J. H. B. Geertzen
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Corresponding author

Correspondence to Johan S. Rietman .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, University of Athens, Athens, Greece

    Damianos E. Sakas

  2. University Hospital of Wales, Cardiff, UK

    Brian A. Simpson

  3. Pacific Pain Treatment Centers, San Francisco, USA

    Elliot S. Krames

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© 2007 Springer-Verlag

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Rietman, J.S., Geertzen, J.H.B. (2007). Efficacy of intrathecal baclofen delivery in the management of severe spasticity in upper motor neuron syndrome. In: Sakas, D.E., Simpson, B.A., Krames, E.S. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/1. Springer, Vienna. https://doi.org/10.1007/978-3-211-33079-1_28

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  • DOI: https://doi.org/10.1007/978-3-211-33079-1_28

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-33078-4

  • Online ISBN: 978-3-211-33079-1

  • eBook Packages: MedicineMedicine (R0)

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