Response of intrathecal baclofen resistance to dose reduction.

Dose stabilization of intrathecal baclofen (ITB) is usually achieved within 6 to 18 months. In some patients, an increase in ITB dose may result in paradoxical unresponsiveness to baclofen. We present two cases demonstrating increased tone and functional decline with increasing ITB doses after a period of clinical stability. In both cases, reduction of ITB dose was associated with marked clinical improvement.