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Intrathecal baclofen in the treatment of spasticity, dystonia and vegetative disorders

  • Chapter
Operative Neuromodulation

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 97/1))

Summary

Baclofen (β-p-chlorophenyl-GABA) binds to a number of spinal and cerebral sites and depresses the excitability of motor neurons. Intrathecal administration induces much higher CSF concentrations compared to the limited passage through the blood-brain barrier after oral administration. The development of reliable implanted pumps allows long-term intrathecal baclofen treatment (ITB).

Baclofen is mainly an antispastic drug and the main indication of ITB is generalized lower limb spasticity in spinal cord injury and multiple sclerosis. The side-effects are due to either drug over-dose or withdrawal and to malfunctions of the implanted device (disconnections of the catheter, infections, etc). Large numbers of patients have been treated over the past twenty years.

More recently, baclofen has been used in the treatment of spasticity of cerebral origin, and in the treatment of other motor disorders, mainly dystonia. The results in cerebral palsy are promising and ITB’s role will probably grow in the management of the movement disorders of these children.

Further studies are required on the exact site of action, on the possible association with other drugs, especially clonidine and on the development of sustained release formulations.

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Author information

Authors and Affiliations

  1. Département de Médecine Physique et Réadaptation, Rue des capucins, BP 40329, 49103, Angers Cedex, France

    Isabelle Richard

  2. Département de Neurochirurgie, Faculté de Médecine, Université d’Angers, Angers, France

    P. Menei

  3. Inserm, U646, Angers, France

    P. Menei

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  1. Isabelle Richard
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  2. P. Menei
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Correspondence to Isabelle Richard .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, University of Athens, Athens, Greece

    Damianos E. Sakas

  2. University Hospital of Wales, Cardiff, UK

    Brian A. Simpson

  3. Pacific Pain Treatment Centers, San Francisco, USA

    Elliot S. Krames

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© 2007 Springer-Verlag

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Richard, I., Menei, P. (2007). Intrathecal baclofen in the treatment of spasticity, dystonia and vegetative disorders. In: Sakas, D.E., Simpson, B.A., Krames, E.S. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/1. Springer, Vienna. https://doi.org/10.1007/978-3-211-33079-1_29

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  • DOI: https://doi.org/10.1007/978-3-211-33079-1_29

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-33078-4

  • Online ISBN: 978-3-211-33079-1

  • eBook Packages: MedicineMedicine (R0)

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