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Intrathecal clonidine for refractory detrusor hyperreflexia in spinal cord injured patients: a preliminary report
P Denys1, E Chartier-Kastler, P Azouvi
1Department of Neurological Rehabilitation, Raymond Poincaré Hospital, Garches, France.
Purpose:
We assessed the urodynamic effect of various doses of intrathecal clonidine on refractory detrusor hyperreflexia in spinal cord injured patients.
Materials And Methods:
Doses of 15, 30 or 45 microg. intrathecal clonidine or placebo were given to 5 chronic complete spinal cord injured patients with detrusor hyperreflexia. Two cystometries were performed before and 5, 30, 60, 90, 120 and 180 minutes after each injection.
Results:
A statistically significant dose dependent decrease in detrusor hyperreflexia was observed in each patient without significant side effect.
Conclusions:
Intrathecal clonidine may represent a conservative reversible treatment for detrusor hyperreflexia via a subcutaneous programmable pump, like that used for baclofen, for spasticity. The long-term efficacy needs to be evaluated.