Skip to main content

Chronic Intrathecal Administration of Baclofen in Treatment of Severe Spasticity

  • Conference paper

Abstract

Bowery [1, 2] established that the main site of action of baclofen (β(p-chlorophenyl)γ-aminobutyric acid) is medullary at the presynaptic level. Baclofen is a specific agonist of GABAB receptors. Autoradiographic studies of Price and coll. [10] showed that GABAB receptors are very abundant in the superficial layers (I-IV) of the posterior columns of the spine. Although baclofen is the most frequently used antispastic drug in the treatment of spasticity, particularly of spinal origin, effective treatment requires high dosage usually in the range of 40–80 mg per day orally. Side effects correlate with the dosage necessary to obtain a therapeutic effect. Metabolic and pharmacological studies [4] performed with the help of baclofen containing radioactive C 14 showed a very low concentration in the central nervous system. Due to the poor permeability of baclofen through the brain barrier, intrathecal administration appeared to be logical.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bowery NG, Hill DR, Hudson AL (1980) Baclofen decreases neurotransmitter release at a novel GABA receptor. Nature 283: 92–94

    Article  PubMed  CAS  Google Scholar 

  2. Bowery NG (1982) Baclofen: 10 years on. TIPS 400–403

    Google Scholar 

  3. Erickson DL, Blacklock JB, Michaelson M, Sperling KB, Lo JN (1985) Control of spasticity by implantable continuous flow morphine pump. Neurosurgery 16: 215–217

    Article  PubMed  CAS  Google Scholar 

  4. Knutsson E, Lindblom U, Martensson A (1974) Plasma and cerebrospinal fluid levels of baclofen (Lioresal) at optimal therapeutic responses in spastic pareses. J Neurol Sci 23: 473–484

    Article  PubMed  CAS  Google Scholar 

  5. Kroin JS, Penn RD, Beissinger RL (1984) Reduced spinal reflexes following intrathecal baclofen in the rabbit. Exp Brain Res 54: 191–194

    Article  PubMed  CAS  Google Scholar 

  6. Lazorthes Y (1984) Chronic cerebellar cortex stimulation for grades spastic cerebral palsy patients. In: Davis R, Bloedel JR (eds) Cerebellar Stimulation for Spasticity and Seizures. CRC Press, New York, pp 217–220

    Google Scholar 

  7. Müller H (1984) Spinal benzodiazepines for treatment of spasticity. Presented at Symposium on Implantable Pumps, Isle of Palms, South Caroline, September 19–22

    Google Scholar 

  8. Penn RD, Kroin JS (1984) Intrathecal baclofen alleviates spinal cord spasticity. Lancet 1: 1078

    Article  PubMed  CAS  Google Scholar 

  9. Penn RD, Kroin JS (1985) Continuous intrathecal baclofen for severe spasticity. Lancet 11: 125–127

    Article  Google Scholar 

  10. Price GW, Wilkin GP, Turnbull MJ, Bowery NG (1984) Are baclofen sensitive GABA-B receptors present on primary afferent terminals of the spinal cord? Nature 307: 71–74

    Article  PubMed  CAS  Google Scholar 

  11. Sedan R, Lazorthes Y (1978) La neurostimulation électrique thérapeutique. Neurochirurgie (suppl 1) 24: 1–125

    PubMed  Google Scholar 

  12. Siegfried J, Lazorthes Y (1985) La neurochirurgie fonctionnelle de l’infirmité motrice d’origine cérébrale. Neurochirurgie [Suppl 1] 31: 1–118

    PubMed  Google Scholar 

  13. Struppler A (1983) Epidural morphine in spasticity (case report). Congress Endorphines, neurohormones and transmitters. Garmisch-Partenkirchen (FRG), 20th June

    Google Scholar 

  14. Waltz JM, Reynolds LO, Riklan M (1981) Multi-lead spinal cord stimulation for control of motor disorders. Appl Neurophysiol 44: 244–257

    PubMed  CAS  Google Scholar 

  15. Willer JL, Russel B (1980) Evidence for a direct spinal mechanism in morphine induced inhibition of nociceptive reflexes in humans. Brain Res 187: 212–215

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1988 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Lazorthes, Y. (1988). Chronic Intrathecal Administration of Baclofen in Treatment of Severe Spasticity. In: Müller, H., Zierski, J., Penn, R.D. (eds) Local-spinal Therapy of Spasticity. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72954-6_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-72954-6_16

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-18295-5

  • Online ISBN: 978-3-642-72954-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics