ERRORS AND LIMITATIONS OF THE MULTIMODALITY CHECKING METHODS OF DEFECTIVE SPINAL INTRATHECAL PUMP SYSTEMS - CASE-REPORT

The loss of benefit from intrathecal baclofen, with increased spastici ty and a discrepancy between the residual and the calculated volume co ntent (underinfusion), made us suspect dysfunction of the intrathecal baclofen infusion in a paraplegic patient. Although all possible usual checking methods were used, no failure in the drug administration dev ice (DAD) could be found. Despite some benefit from increasing the dai ly dose of baclofen, it has not been possible to control the spastic s ymptoms. Surgery was therefore decided upon, and a small leak at the e nd of the catheter tip was discovered. Surgeons and physicians should be aware that checking methods of DAD cannot exclude failure of the sy stem. Their errors and limitations are discussed.