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Intrathecal baclofen and the H-reflex.
R A Macdonell1, A Talalla, M Swash
1Department of Neurology, London Hospital, United Kingdom.
Journal of Neurology, Neurosurgery, and Psychiatry
|September 1, 1989
Summary
Intrathecal baclofen effectively reduced lower limb spasticity in spinal cord injury patients. The Hmax/Mmax ratio showed potential for optimizing chronic baclofen dosage.
Area of Science:
- Neuroscience
- Clinical Pharmacology
- Rehabilitation Medicine
Background:
- Severe lower limb spasticity is a common complication of traumatic spinal cord injury.
- Intrathecal baclofen is a treatment option for refractory spasticity.
Purpose of the Study:
- To evaluate the efficacy of intrathecal baclofen in reducing spasticity in patients with spinal cord injury.
- To assess the utility of the Hmax/Mmax ratio in monitoring treatment response.
Main Methods:
- Six patients with severe lower limb spasticity due to spinal cord injury received intrathecal baclofen.
- Spasticity was assessed clinically.
- The Hmax/Mmax ratio of the soleus muscle's H reflex and M response was measured.
Main Results:
- All patients experienced a reduction in spasticity after intrathecal baclofen administration.
- Four patients showed a decrease in the Hmax/Mmax ratio.
- The Hmax/Mmax ratio correlated with clinical improvements in spasticity.
Conclusions:
- Intrathecal baclofen is effective in managing lower limb spasticity post-spinal cord injury.
- The Hmax/Mmax ratio may serve as a useful objective measure for optimizing intrathecal baclofen dosage, especially for long-term treatment.