Chronic Intrathecal Baclofen for Severe Rigidity and Spasms

Abstract

Since its introduction over fifteen years ago, baclofen has proven to be the most single effective oral drug for treating spasticity. The results have been shown to be most pronounced in patients with spinal cord injuries and multiple sclerosis, and the symptoms that are most improved are spasms and rigidity in the limbs. The early study by Duncan et al. [1] demonstrated in a double-blind manner these important effects. They reported an improvement in daytime spasms in 72% of patients and a decrease in resistance to passive movement in 55%. When one looks at the actual figures, it is clear that baclofen has an effect statistically, but that overall, it is only a moderately effective treatment. The lack of effect of baclofen in many patients and the only mild reduction in symptoms raises the question of whether efficacy is limited by the route of administration or if the drug intrinsically is limited in its effects.