Intrathecal baclofen therapy and multiple sclerosis: outcomes and patient satisfaction

2006 ◽  
Vol 21 (2) ◽  
pp. E6 ◽  
Author(s):  
John R. Vender ◽  
Mary Hughes ◽  
Betsy D. Hughes ◽  
Sydney Hester ◽  
Stephen Holsenback ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Patient Outcomes ◽  
Test Dose ◽  
Intrathecal Baclofen ◽  
Response To Therapy ◽  
Intrathecal Baclofen Therapy ◽  
Short And Long Term ◽  
Term Response ◽  
Common Variable

ObjectIn this study the authors provide an assessment of intrathecal baclofen (ITB) therapy and evaluate patient outcomes and satisfaction.MethodsRecords for patients with multiple sclerosis who were selected as candidates for ITB therapy were reviewed for their response to test dose, surgical technique, surgery- and pump-related complications, and short- and long-term response to therapy. Family and caregiver assessments of the value of ITB therapy were also reviewed.ConclusionsIntrathecal baclofen therapy is safe and effective. Most patients and caregivers express satisfaction with the therapy and would recommend it to other patients. Spasm frequency appears to be the single most common variable positively affected by therapy.

scholarly journals Short and long term response to argon plasma therapy for hemorrhagic radiation proctitis

2019 ◽  
Vol 111 ◽  
Author(s):  
Elizabeth Montes de Oca Megías ◽  
Maricela Morera Pérez ◽  
Guillermo Noa Pedroso ◽  
Felipe Piñol Jiménez ◽  
Mildred Armenteros Torres
Keyword(s):  
Argon Plasma ◽  
Radiation Proctitis ◽  
Plasma Therapy ◽  
Short And Long Term ◽  
Term Response

Occult Hydrocephalus in Children with Cerebral Palsy

Neurosurgery ◽  
2005 ◽  
Vol 56 (1) ◽  
pp. 93-97 ◽  
Author(s):  
A Leland Albright ◽  
Susan Ferson ◽  
Signe Carlos
Keyword(s):  
Cerebral Palsy ◽  
Periventricular Leukomalacia ◽  
Intrathecal Baclofen ◽  
Multicenter Studies ◽  
Csf Shunts ◽  
Csf Pressure ◽  
Intrathecal Baclofen Therapy ◽  
Children With Cerebral Palsy ◽  
Csf Leaks

Abstract OBJECTIVE: Many children with cerebral palsy have chronic ventriculomegaly as a consequence of perinatal intraventricular hemorrhage or periventricular leukomalacia, without symptoms of hydrocephalus. Children with cerebral palsy who are treated with intrathecal baclofen have a higher rate of cerebrospinal fluid (CSF) leaks along the baclofen catheter than do adults treated with intrathecal baclofen. We postulated that the cause of the increased frequency of CSF leaks was increased CSF pressure, that is, occult hydrocephalus. METHODS: Lumbar punctures were performed in 24 children with cerebral palsy and asymptomatic ventriculomegaly. Their median age was 4.7 years. Mild or moderate ventriculomegaly was present in 23 children and severe ventriculomegaly was present in 1 child. RESULTS: Opening pressures were abnormally high in 23 (96%) of 24 children and ranged from 22 to 41 cm H2O (mean, 27.3 cm H2O). Opening pressures did not correlate with the extent of ventriculomegaly. CONCLUSION: Children with cerebral palsy and ventriculomegaly seem to have a high incidence of increased CSF pressure, and thus, of occult hydrocephalus. The increased pressure is probably a significant cause of the increased frequency of CSF leaks for these children during intrathecal baclofen therapy. The long-term risks of untreated increased CSF pressures in this patient population are not known but are cause for concern. Treatment with CSF shunts offers the potential of improved development, which was reported anecdotally in some children who were treated with ventriculoperitoneal shunts after their pressure was found to be increased. Prospective multicenter studies of this problem are needed.

scholarly journals Identification of Monotonically Differentially Expressed Genes for IFN-β-Treated Multiple Sclerosis Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Suyan Tian ◽  
Lei Zhang
Keyword(s):  
Gene Expression ◽  
Multiple Sclerosis ◽  
Expression Profiles ◽  
Gene Expression Profiles ◽  
Biologically Relevant ◽  
Therapeutic Mechanism ◽  
The Central Nervous System ◽  
Multiple Sclerosis Patients ◽  
Term Response

Multiple sclerosis (MS) is a common neurological disability of the central nervous system. Immune-modulatory therapy with interferon-β (IFN-β) has been used as a first-line treatment to prevent relapses in MS patients. While the therapeutic mechanism of IFN-β has not been fully elucidated, the data of microarray experiments that collected longitudinal gene expression profiles to evaluate the long-term response of IFN-β treatment have been analyzed using statistical methods that were incapable of dealing with such data. In this study, the GeneRank method was applied to generate weighted gene expression values and the monotonically expressed genes (MEGs) for both IFN-β treatment responders and nonresponders were identified. The proposed procedure identified 13 MEGs for the responders and 2 MEGs for the nonresponders, most of which are biologically relevant to MS. Our work here provides some useful insight into the mechanism of IFN-β treatment for MS patients. A full understanding of the therapeutic mechanism will enable a more personalized treatment strategy possible.

Intrathecal baclofen for intractable spasticity of spinal origin: results of a long-term multicenter study

1993 ◽  
Vol 78 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Robert J. Coffey ◽  
David Cahill ◽  
William Steers ◽  
T. S. Park ◽  
Joe Ordia ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Intrathecal Baclofen ◽  
Neurological Deficits ◽  
Pump System ◽  
Postoperative Score ◽  
Long Term Treatment ◽  
Cord Injury

✓ A total of 93 patients with intractable spasticity due to either spinal cord injury (59 cases), multiple sclerosis (31 cases), or other spinal pathology (three cases) were entered into a randomized double-blind placebocontrolled screening protocol of intrathecal baclofen test injections. Of the 88 patients who responded to an intrathecal bolus of 50, 75, or 100 µg of baclofen, 75 underwent implantation of a programmable pump system for chronic therapy. Patients were followed for 5 to 41 months after surgery (mean 19 months). No deaths or new permanent neurological deficits occurred as a result of surgery or chronic intrathecal baclofen administration. Rigidity was reduced from a mean preoperative Ashworth scale score of 3.9 to a mean postoperative score of 1.7. Muscle spasms were reduced from a mean preoperative score of 3.1 (on a fourpoint scale) to a mean postoperative score of 1.0. Although the dose of intrathecal baclofen required to control spasticity increased with time, drug tolerance was not a limiting factor in this study. Only one patient withdrew from the study because of a late surgical complication (pump pocket infection). Another patient received an intrathecal baclofen overdose because of a human error in programming the pump. The results of this study indicate that intrathecal baclofen infusion can be safe and effective for the long-term treatment of intractable spasticity in patients with spinal cord injury or multiple sclerosis.

Poster 67 Best Practices in Intrathecal Baclofen Therapy: Dosing and Long-Term Management

PM&R ◽  
2015 ◽  
Vol 7 ◽  
pp. S113-S114
Author(s):  
Michael Saulino ◽  
Roy L. Adair ◽  
Judith l. Gooch ◽  
Mary Elizabeth S. Nelson ◽  
Andrea P. Toomer ◽  
...  
Keyword(s):  
Best Practices ◽  
Intrathecal Baclofen ◽  
Intrathecal Baclofen Therapy ◽  
Term Management
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