CONTINUOUS INTRATHECAL BACLOFEN INFUSION FOR SPASTICITY OF CEREBRAL ORIGIN

Objective.-To determine if continuous intrathecal baclofen infusion (C IBI) would provide continuous relief of spasticity in patients with sp asticity of cerebral origin, especially children with cerebral palsy. Design.-Prospective, unblinded trial, before and after CIBI. Setting.- Children's Hospital of Pittsburgh (Pa). Patients.-Thirty-seven patient s, 5 to 27 years of age, with spasticity of cerebral origin. Intervent ion.-Continuous intrathecal baclofen infusion for 3 to 48 months. Main Outcome Measures.-Muscle tone, range of motion, upper extremity timed tasks, activities of daily living (ADLs). Results.-Six and 12 months after CIBI, muscle tone was significantly decreased in the upper (P=.0 4) and lower (P=.001) extremities. There was a significant relationshi p between baclofen dosage and muscle tone in the upper (P=.02) and low er (P=.001) extremities. Hamstring motion, upper extremity function, a nd ADLs were significantly improved in 25 patients who were capable of self-care. Conclusion.-Spasticity of cerebral origin can be effective ly treated with CIBI. Because baclofen dosages can be titrated for the desired clinical response, CIBI is particularly useful for patients w ho need some spasticity to stand and ambulate.