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Neuromodulation der Spastik bei Kindern durch intrathekal verabreichtes Baclofen

Neuromodulation of spasticity in children by intrathecal baclofen

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Zusammenfassung

Hintergrund

Die intrathekale Behandlung mit Baclofen (ITB) ist ein Bestandteil der komplexen Therapie von Patienten mit zerebraler Spastik mit dem Ziel, die Motorik zu verbessern und die Schmerzintensität zu mindern.

Material und Methodik

Die ITB wird seit 1999 im Orthopädischen Spital Speising durchgeführt. Von 1999–2006 wurden 15 Kinder im Alter zwischen 3 und 16 Jahren ausgewählt.

Ergebnisse

Das durchschnittliche Ausmaß der Spastik nach Ashworth (Skala 1–5) sank nach der ITB von 4,38 auf 3,0. Die im Sitzen verbrachte Zeit verlängerte sich von 3,3 auf 5,8 h/Tag, die Schmerzintensität (Visuelle Analogskala, VAS 1–10) sank von 4,2 auf 0,6. Der Pflegeaufwand verringerte sich von 7,5 auf 3,4 (VAS 1–10). Ebenfalls verbesserte sich bei den Kindern die Stimmungslage, des Weiteren bei 8 Kindern die Schluckfähigkeit, die Kopfhaltung und die Konzentrationsfähigkeit.

Schlussfolgerung

Die ITB ermöglicht eine Neuromodulation auch bei den Patienten im Kindesalter, bei denen die Spastik Bestandteil einer komplexen neuromotorischen Symptomatik ist.

Abstract

Introduction

Treatment with intrathecal baclofen (ITB) is an important part of the complex therapy of patients with cerebral spasticity aiming to improve the motoric functions and to reduce pain intensity.

Material and methods

ITB was started in the Orthopaedic Hospital in Speising in 1999. From 1999 to 2006 a total of 15 children aged 3 to 16 years old were selected for this special treatment.

Results

The average degree of spasticity according to Ashworth (scale 1–5) could be reduced by ITB from 4.38 to 3.0, the time spent sitting could be increased from 3.3 to 5.8h per day and the pain intensity (VAS 1–10) could be reduced from 4.2 to 0.6. The time necessary for nursing treatment was shortened from 7.5 to 3.4 (VAS 1–10). Also improved was the emotional situation, the ability to swallow, the posture of the head and the concentration ability.

Conclusion

ITB provides neuromodulation even in pediatric patients with complex neuromotoric spasticity.

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Authors and Affiliations

  1. Abteilung für Anästhesie und Intensivmedizin, Orthopädisches Spital Speising GmbH, Speisinger Str. 109, 1130, Wien, Österreich

    R. Cumlivski & G. Redl

  2. Kinderorthopädische Abteilung, Orthopädisches Spital Speising GmbH, Wien, Österreich

    W. Strobl, W. Girsch & A. Krebs

  3. Neurologisches Krankenhaus der Stadt Wien, Rosenhügel, Wien, Österreich

    P. Machowetz

Authors
  1. R. Cumlivski
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  2. G. Redl
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  3. W. Strobl
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  4. W. Girsch
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  5. A. Krebs
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  6. P. Machowetz
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Correspondence to R. Cumlivski.

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Cumlivski, R., Redl, G., Strobl, W. et al. Neuromodulation der Spastik bei Kindern durch intrathekal verabreichtes Baclofen. Schmerz 23, 592–599 (2009). https://doi.org/10.1007/s00482-009-0841-2

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  • DOI: https://doi.org/10.1007/s00482-009-0841-2

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