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Intrathecal baclofen therapy in children

A Leland Albright1, Susan S Ferson

  • 1Department of Neurosurgery, University of Wisconsin School of Medicine, Madison, Wisconsin 53792, USA. l.albright@neurosurg.wisc.edu

Neurosurgical Focus
|August 22, 2006
PubMed

Insights

Intrathecal baclofen (ITB) therapy is a standard treatment for severe spasticity and dystonia in children, offering long-term benefits in function and comfort. While complications exist, the advantages of ITB therapy generally outweigh the risks for pediatric patients.

Area of Science:

  • Neurology
  • Pediatric Medicine
  • Rehabilitation

Background:

  • Intrathecal baclofen (ITB) therapy, introduced in the late 1980s, is a primary treatment for severe generalized spasticity and dystonia in pediatric populations.
  • ITB therapy has demonstrated efficacy in reducing spasticity and dystonia, leading to improved physical function and reduced musculoskeletal contractures.
  • The therapy has shown sustained effectiveness for spasticity up to 17 years and for dystonia up to 10 years in children.

Purpose of the Study:

  • To review the established benefits and long-term effectiveness of intrathecal baclofen therapy in managing severe generalized spasticity and dystonia in children.
  • To assess the impact of ITB therapy on functional outcomes, comfort, and ease of care in pediatric patients.
  • To acknowledge potential complications associated with ITB therapy and weigh them against the therapeutic advantages.

Main Methods:

  • Review of existing literature and clinical data on intrathecal baclofen therapy in pediatric patients.
  • Analysis of reported outcomes related to spasticity reduction, dystonia management, functional improvement, and patient comfort.
  • Evaluation of the long-term efficacy and safety profile, including common complications.

Main Results:

  • ITB therapy effectively decreases spasticity in extremities and secondary generalized dystonia.
  • Significant improvements in comfort and ease of care (approx. 85%) and function (approx. 33%) are associated with ITB therapy for dystonia.
  • Long-term effectiveness is established, with sustained benefits observed for up to 17 years for spasticity and 10 years for dystonia.

Conclusions:

  • Intrathecal baclofen therapy remains a cornerstone treatment for severe pediatric spasticity and dystonia, offering substantial and durable benefits.
  • Despite potential complications like infections and device malfunctions, the overall therapeutic benefits of ITB therapy are considered to outweigh the associated risks.
  • Further research is warranted to explore the effects of ITB on other movement disorders, such as athetosis and chorea, in pediatric populations.

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