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Terapia intratecal con baclofeno en niños: pruebas, determinación de dosis y complicaciones - Una experiencia de un
Andrea Held1, Camilla de Laurentis1, Claire Mietton2
1Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.
Pediatric neurology
|February 11, 2026
Resumen
La optimización de la terapia de baclofeno intratecal (ITB) para la espasticidad requiere un proceso de búsqueda de dosis personalizado y en varios pasos. Las necesidades y la variabilidad individuales del paciente son cruciales para los resultados exitosos del tratamiento en pacientes pediátricos.
Área de la Ciencia:
- Neurología Neurología.
- Medicina Pediátrica La medicina pediátrica es una especialidad de la medicina pediátrica.
- Farmacología Farmacología.
Sus antecedentes:
- El baclofeno intratecal (ITB) es un agonista del GABA utilizado para tratar la espasticidad en pacientes pediátricos y adultos.
- El tratamiento de la ITB requiere ajustes graduales de la dosis para obtener resultados óptimos en el paciente y una mejora funcional.
- Las metas individualizadas y las patologías específicas requieren enfoques terapéuticos personalizados.
Objetivo del estudio:
- Revisar la experiencia con la implantación de la bomba de baclofeno intratecal en pacientes pediátricos.
- Para analizar el proceso de determinación de la dosis, incluidas las dosis de prueba y las complicaciones.
- Para identificar cualquier diferencia significativa entre los subgrupos de pacientes.
Principales métodos:
- Revisión retrospectiva de 43 pacientes pediátricos implantados con bombas ITB desde agosto de 2021 hasta diciembre de 2024.
- Análisis de la administración de la dosis de prueba, la titulación de la dosis y las complicaciones asociadas.
- Análisis de subgrupos para detectar diferencias estadísticamente significativas.
Principales resultados:
- 35 pacientes recibieron un bolo a través de punción lumbar; 6 a través de un depósito subcutáneo.
- La dosis inicial promedio fue de 69 mcg/día, con un aumento medio del 52% durante el seguimiento.
- Las tasas de revisión acumuladas a los 30 días, 3 meses y 6 meses fueron de 6.9%, 7.7% y 11.8%, respectivamente. No se encontraron diferencias significativas entre los subgrupos.
Conclusiones:
- El proceso de determinación de la dosis para ITB es largo e implica múltiples pasos.
- La alta variabilidad interindividual en la respuesta requiere un enfoque personalizado para la titulación de la dosis.
- La adaptación de la dosis de ITB es esencial para optimizar el manejo de la espasticidad en pacientes pediátricos.
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