Intrathecal baclofen therapy for severe spasticity in an adult with tethered cord syndrome: a case report.
Baclofen
Intrathecal infusion
Spasticity
Tethered cord syndrome
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
02 Sep 2021
02 Sep 2021
Historique:
received:
19
07
2020
accepted:
05
08
2021
entrez:
2
9
2021
pubmed:
3
9
2021
medline:
4
9
2021
Statut:
epublish
Résumé
Patients with tethered cord syndrome often suffer severe spasticity. To the best of our knowledge, intrathecal baclofen (ITB) therapy in a patient with tethered cord syndrome has not been reported previously. We describe a case in which ITB therapy was useful for treating severe spasticity in an adult with tethered cord syndrome. We present the case of a 50-year-old Japanese woman with tethered cord syndrome and related conditions suffering from severe spasticity and pain in the lower limbs. She was born with a lumbosacral myelomeningocele, which was closed in the neonatal period. For 4-5 years before this presentation, spasticity in the lower limbs had been exacerbated without any obvious cause. She received rehabilitation and pharmacotherapy from a local doctor, but symptoms were unimproved, and her previous doctor referred her to this department. A test with 50 μg of intrathecally delivered baclofen showed total relief of spasticity and pain, so a pump was implanted for continuous baclofen delivery. During 24 months of follow-up, spasticity has remained under excellent control with baclofen at 38.5-41.0 μg/day. ITB therapy proved extremely effective in this adult with severe spasticity from tethered code syndrome.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with tethered cord syndrome often suffer severe spasticity. To the best of our knowledge, intrathecal baclofen (ITB) therapy in a patient with tethered cord syndrome has not been reported previously. We describe a case in which ITB therapy was useful for treating severe spasticity in an adult with tethered cord syndrome.
CASE PRESENTATION
METHODS
We present the case of a 50-year-old Japanese woman with tethered cord syndrome and related conditions suffering from severe spasticity and pain in the lower limbs. She was born with a lumbosacral myelomeningocele, which was closed in the neonatal period. For 4-5 years before this presentation, spasticity in the lower limbs had been exacerbated without any obvious cause. She received rehabilitation and pharmacotherapy from a local doctor, but symptoms were unimproved, and her previous doctor referred her to this department. A test with 50 μg of intrathecally delivered baclofen showed total relief of spasticity and pain, so a pump was implanted for continuous baclofen delivery. During 24 months of follow-up, spasticity has remained under excellent control with baclofen at 38.5-41.0 μg/day.
CONCLUSIONS
CONCLUSIONS
ITB therapy proved extremely effective in this adult with severe spasticity from tethered code syndrome.
Identifiants
pubmed: 34470662
doi: 10.1186/s13256-021-03049-0
pii: 10.1186/s13256-021-03049-0
pmc: PMC8411508
doi:
Substances chimiques
Muscle Relaxants, Central
0
Baclofen
H789N3FKE8
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
442Informations de copyright
© 2021. The Author(s).
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