Article

OBJECTIVE: To assess the safety and efficacy of intrathecal baclofen (ITB)
therapy for severe spasticity in patients with upper-motor neuron predominant
motor neuron disease (U-MND). METHODS: A total of 44 patients with U-MND were
referred for discussion of ITB therapy. Baseline and outcomes data were extracted
on 35 patients from a clinical spasticity registry at a tertiary referral center.
Patients choosing to initiate ITB (n = 20) were compared with those choosing
conservative therapy (n = 15). RESULTS: At baseline, lower average pain score in
the non-ITB group was the only significant difference between the 2 groups. A
significant reduction in pain scores, Modified Ashworth Scale (MAS), Spasm
Frequency Scale, and requirement for oral spasticity medications was observed
within the ITB group at early and late follow-up. Within the non-ITB group, there
was a significant increase in MAS scores between baseline and late follow-up. A statistically significant difference favoring the ITB group was observed for
change in MAS score (P < .0001), Numerical Rating Scale pain score (P = .04),
dose of oral baclofen (P = .002) and tizanidine (P = .003), and number of oral
medications for spasticity
(P = .002). There was no difference between the 2
groups in the progression of hip flexor weakness or in the proportion of patients
who became nonambulatory. CONCLUSIONS: Our findings suggest that ITB can
effectively reduce spasticity and related symptoms without compromising function
in selected patients with U-MND.

Langue : ANGLAIS