Intrathecal baclofen in the treatment of spasticity.

Spasticity is a disorder of the sensorimotor system resulting in velocity-dependent increased muscle tone and tendon reflexes. Intrathecal baclofen is currently the most effective means of treating diffuse abnormal spasticity of both cerebral and spinal origin in the adult and pediatric patient. Careful patient assessment, selection and continued therapies are essential to a successful intrathecal baclofen management program. Once a patient receives a baclofen pump, close monitoring is needed for dose adjustment and pump problems. Baclofen overdose and withdrawal by either system failure or human error can cause significant side effects and be life threatening. Excellent understanding of the baclofen delivery system, programming and dose effects are needed to evaluate any patient complaints. Future uses of intrathecal pump therapy includes use of other intrathecal drugs besides baclofen (or in combination with baclofen) and the effects of placing the catheter tip at various spinal levels. At the University of Minnesota, Sister Kenny Institute and Gillette Children's Specialty Healthcare our experience has shown excellent results with this form of therapy over the last 12-16 years.