Article

A 43-year-old woman with cerebral palsy and disabling spasticity
underwent a series of 4 implantations of intrathecal baclofen pumps, performed by
two teams. A history of 3 aseptic local skin reactions over the site of insertion
started 4 months after the first insertion, once with partial pump exposure.
There were no clinical or biological signs of infection. Skin patch tests were
negative. Relocation of the system was followed by a relapse, while removal of
the pump was followed each time by complete resolution of the symptoms.
Histological findings showed slight mononuclear dermal infiltration without
epidermal lesions, which excluded contact dermatitis. Pump intolerance with a
foreign-body reaction was diagnosed. A pump wrapped with polyethylene
terephthalate was reimplanted. No recurrence of symptoms occurred after a 3-year
follow-up period, with improvement in impairment, activity and satisfaction due
to intrathecal baclofen therapy. CONCLUSION: A foreign-body reaction after
intrathecal baclofen pump implantation is a rare complication, which has not been
reported previously, and which is associated with negative skin patch tests. In
cases with no signs of infection, skin intolerance must be suspected and
dermatological assessments should be carried out. Replacement with a pump wrapped
in an inert coating is an effective and available solution.

Langue : ANGLAIS