Poster 47 treatment of severe spasticity with intrathecal baclofen therapy in ambulatory multiple sclerosis patients: 6-month follow-up. Francois A. Bethoux, MD (Mellen Center for MS Treatment Res, Cleveland, OH); Darlene Stough, RN; Matthew Sutliff, PT, e-mail: [email protected]

2004 ◽  
Vol 85 (9) ◽  
pp. e19
Keyword(s):  
Multiple Sclerosis ◽  
Intrathecal Baclofen ◽  
Intrathecal Baclofen Therapy ◽  
Severe Spasticity ◽  
Multiple Sclerosis Patients ◽  
E Mail

393 LONG TERM FOLLOW-UP AFTER CONTINUOUS INTRATHECAL BACLOFEN THERAPY FOR SEVERE SPASTICITY

2010 ◽  
Vol 4 (S1) ◽  
pp. 112-112
Author(s):  
E. Anastasiou ◽  
A. Tzortzopoulou ◽  
A. Alexandropoulou ◽  
K. Rizos ◽  
A. Karakosta ◽  
...  
Keyword(s):  
Intrathecal Baclofen ◽  
Intrathecal Baclofen Therapy ◽  
Severe Spasticity ◽  
Long Term Follow Up

Intrathecal baclofen for treatment of spasticity of multiple sclerosis patients

2006 ◽  
Vol 12 (1) ◽  
pp. 101-103 ◽  
Author(s):  
D Ben smail ◽  
A Peskine ◽  
N Roche ◽  
L Mailhan ◽  
J B Thiébaut ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Intrathecal Baclofen ◽  
Advanced Stage ◽  
Rehabilitation Unit ◽  
Severe Spasticity ◽  
Pump Placement ◽  
Case Files ◽  
Multiple Sclerosis Patients ◽  
Almost All ◽  
Over Time

We conducted a retrospective study of the case files of 64 multiple sclerosis (MS) patients presenting severe spasticity, who had received intrathecal (IT) baclofen test injections between 1992 and 2004 in a rehabilitation unit. In almost all cases of our series, IT baclofen was proposed to patients who were no longer able to walk. IT baclofen is a safe and effective treatment to reduce spasticity in MS patients. Despite an advanced stage of the disease at the time of pump placement, the complication rate was low and the efficacy of this treatment was maintained over time.

Guided intrathecal baclofen administration by using soleus stretch reflex in moderate-severe spastic multiple sclerosis patients with implanted pump

2004 ◽  
Vol 10 (5) ◽  
pp. 521-525 ◽  
Author(s):  
J F Nielsen ◽  
T Sinkjær
Keyword(s):  
Multiple Sclerosis ◽  
Ankle Joint ◽  
Clinical Assessment ◽  
Strong Correlation ◽  
Stretch Reflex ◽  
Intrathecal Baclofen ◽  
Short Latency ◽  
Severe Spasticity ◽  
Multiple Sclerosis Patients ◽  
Ashworth Scale

We tested the hypothesis that changes in soleus stretch reflex was correlated to changes in intrathecal baclofen dose in 12 multiple sclerosis patients with moderate-severe spasticity treated with intrathecal baclofen pump. Twice patients were evaluated clinically and biomechanically. The short-latency soleus stretch reflex was elicited by rotating the ankle joint 48 with a velocity from 3.1 to 1808/s. There was a strong correlation between changes in intrathecal baclofen dose and amplitude of the short-latency stretch reflex (r=- 0.88, PB < 0.001), which means that with an increase in baclofen dose there is a decrease in the amplitude. In contrast, no correlation exists between changes in intrathecal baclofen dose and clinical assessment of spasticity by using the Ashworth scale. The amplitude of the stretch reflex was very small (5 mV) compared with previous findings (> 50 μV), which indicates an effective antispastic effect of intrathecal baclofen. We suggest that clinical evaluation of spasticity using Ashworth scale is insensitive to detect minor changes in moderate-severe spasticity and consequently might not be very useful in evaluating spasticity in relation to ambulatory filling of baclofen pumps. The soleus stretch reflex might be useful in situations when there is doubt about the effect of intrathecally administered baclofen.

Managing Spasticity in People With Multiple Sclerosis: A Goal-Oriented Approach to Intrathecal Baclofen Therapy

2001 ◽  
Vol 3 (4) ◽  
pp. 10-25 ◽  
Author(s):  
Louise Jarrett ◽  
Siobhan M. Leary ◽  
Bernadette Porter ◽  
Davina Richardson ◽  
Tiziana Rosso ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Intrathecal Baclofen ◽  
Sustained Improvement ◽  
Careful Patient ◽  
Intrathecal Baclofen Therapy ◽  
Severe Spasticity ◽  
Ongoing Evaluation ◽  
Medical Side ◽  
Oriented Approach ◽  
Over Time

ABSTRACT The effectiveness of intrathecal baclofen therapy (ITB) in the management of severe spasticity in people with multiple sclerosis (MS) was reviewed retrospectively. The multidisciplinary team reviewed the medical, therapy, and nursing notes of 19 people with MS who were treated with ITB. The audited information included surgical procedures, postoperative complications, medical side effects, dose requirements, and multidisciplinary input. Seventeen people were included in the audit. A total of 23 problems and 34 functional goals as objects for ITB treatment were recorded. Eighty-seven percent of the patients had sustained improvement in at least one problem, and 79% in at least one goal. Only two patients had no sustained improvement in any problem or goal. These results suggest that ITB can be an effective intervention in people with severe spasticity in MS. However, this approach requires careful patient selection, a dynamic goal-oriented approach, expert implantation, and ongoing evaluation of individual responses to treatment over time. (Int J MS Care. 2001; 3(4): 10–21)

scholarly journals Multiple Sclerosis Treated with Antithymocyte Globulin — A Five Year Follow-Up

1978 ◽  
Vol 5 (2) ◽  
pp. 175-178 ◽  
Author(s):  
L.F. Kastrukoff ◽  
D.R. McLean ◽  
T.A. McPherson
Keyword(s):  
Multiple Sclerosis ◽  
Total Protein ◽  
Antithymocyte Globulin ◽  
Gamma Globulin ◽  
Multiple Sclerosis Patients ◽  
Term Benefit

SUMMARY:Multiple sclerosis patients treated with antithymocyte globulin (ATG) were re-evaluated after five years. No long term benefit was found. Notably, the group of patients with an elevated gamma globulin to total protein ration in their C.S.F. and who did particularly well after treatment with ATG also failed to show any long term benefit. Few long term detrimental effects of ATG immunosuppression were identified. The implications of the results are discussed as they relate to the use of immunosuppression in multiple sclerosis.

Multimodal evoked potentials follow up in multiple sclerosis patients under fingolimod therapy

2016 ◽  
Vol 365 ◽  
pp. 143-146 ◽  
Author(s):  
R. Iodice ◽  
A. Carotenuto ◽  
R. Dubbioso ◽  
I. Cerillo ◽  
L. Santoro ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Evoked Potentials ◽  
Multimodal Evoked Potentials ◽  
Multiple Sclerosis Patients

scholarly journals Safety of alemtuzumab in a nationwide cohort of Finnish multiple sclerosis patients

2021 ◽  
Author(s):  
Ilkka Rauma ◽  
Tiina Mustonen ◽  
Juha Matti Seppä ◽  
Maritta Ukkonen ◽  
Marianne Männikkö ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Adverse Events ◽  
Case Series ◽  
Retrospective Case ◽  
Serious Adverse Events ◽  
Highly Active ◽  
Disease Modifying Therapy ◽  
Case Series Study ◽  
Multiple Sclerosis Patients

Abstract Background Alemtuzumab is an effective disease-modifying therapy (DMT) for highly active multiple sclerosis (MS). However, safety concerns limit its use in clinical practice. Objectives To evaluate the safety of alemtuzumab in a nationwide cohort of Finnish MS patients. Methods In this retrospective case series study, we analyzed the data of all but two MS patients who had received alemtuzumab in Finland until 2019. Data were systematically collected from patient files. Results Altogether 121 patients were identified, most of whom had received previous DMTs (82.6%). Median follow-up time after treatment initiation was 30.3 months and exceeded 24 months in 78 patients. Infusion-associated reactions (IARs) were observed in 84.3%, 57.3%, and 57.1% of patients during alemtuzumab courses 1–3, respectively. Serious adverse events (SAEs) were observed in 32.2% of patients, serious IARs in 12.4% of patients, and SAEs other than IARs in 23.1% of patients. Autoimmune adverse events were observed in 30.6% of patients. One patient died of hemophagocytic lymphohistiocytosis, and one patient died of pneumonia. A previously unreported case of thrombotic thrombocytopenic purpura was documented. Conclusions SAEs were more frequent in the present cohort than in previous studies. Even though alemtuzumab is a highly effective therapy for MS, vigorous monitoring with a long enough follow-up time is advised.

Fatigue, mood and quality of life improve in MS patients after progressive resistance training

2010 ◽  
Vol 16 (4) ◽  
pp. 480-490 ◽  
Author(s):  
U. Dalgas ◽  
E. Stenager ◽  
J. Jakobsen ◽  
T. Petersen ◽  
HJ Hansen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Resistance Training ◽  
Beneficial Effect ◽  
Control Group ◽  
Progressive Resistance Training ◽  
Multiple Sclerosis Patients ◽  
Progressive Resistance

Fatigue occurs in the majority of multiple sclerosis patients and therapeutic possibilities are few. Fatigue, mood and quality of life were studied in patients with multiple sclerosis following progressive resistance training leading to improvement of muscular strength and functional capacity. Fatigue (Fatigue Severity Scale, FSS), mood (Major Depression Inventory, MDI) and quality of life (physical and mental component scores, PCS and MCS, of SF36) were scored at start, end and follow-up of a randomized controlled clinical trial of 12 weeks of progressive resistance training in moderately disabled (Expanded Disability Status Scale, EDSS: 3—5.5) multiple sclerosis patients including a Control group ( n = 15) and an Exercise group ( n = 16). Fatigue (FSS > 4) was present in all patients. Scores of FSS, MDI, PCS—SF36 and MCS—SF36 were comparable at start of study in the two groups. Fatigue improved during exercise by —0.6 (95% confidence interval (CI) —1.4 to 0.4) a.u. vs. 0.1 (95% CI —0.4 to 0.6) a.u. in controls ( p = 0.04), mood improved by —2.4 (95% CI —4.1 to 0.7) a.u. vs. 1.1 (—1.2 to 3.4) a.u. in controls ( p = 0.01) and quality of life (PCS—SF36) improved by 3.5 (95% CI 1.4—5.7) a.u. vs. —1.0 (95% CI —3.4—1.4) a.u. in controls ( p = 0.01). The beneficial effect of progressive resistance training on all scores was maintained at follow-up after further 12 weeks. Fatigue, mood and quality of life all improved following progressive resistance training, the beneficial effect being maintained for at least 12 weeks after end of intervention.

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