The aim of this study was to evaluate the effects of intrathecal bacolfen (ITB) on patients with severe generalized dystonia. Eighty-six participants ranging in age from 3 to 42 years (median age 13 years) with generalized dystonia refractory to oral medications were offered treatment with ITB. Dystonia was associated with cerebral palsy in 71\% of participants. Response to ITB was tested by continuous infusions in 72\%, and by bolus injections in 17\% of participants who had both dystonia and spasticity. Ninety-one percent of participants responded to the screening infusion and 93\% to the bolus injections. Pumps were implanted in 77 participants. Dystonia scores at 3, 6, 12, and 24 months were significantly decreased (p<0.005) compared with baseline scores. Dystonia scores were significantly lower in those with intrathecal catheters positioned at T4, or higher than in those with catheters at T6 or lower (p=0.005). Ninety-two percent of participants implanted with a pump retained their responses to ITB during a median follow-up of 29 months. Patient questionnaires indicated that quality of life and ease of care improved in 86\% and speech improved in 33\%. Side effects of ITB occurred in 26\% of participants. Surgical complications occurred in 38\% and included CSF leaks, infections, and catheter problems. ITB is probably the treatment of choice for generalized dystonia if oral medications are ineffective.
%0 Journal Article
%1 Albright2001
%A Albright, A. L.
%A Barry, M. J.
%A Shafton, D. H.
%A Ferson, S. S.
%D 2001
%J Dev Med Child Neurol
%K Adolescent; Adult; Baclofen; Cerebral Palsy; Child; Child, Preschool; Dystonia; Female; Follow-Up Studies; Humans; Infusion Pumps, Implantable; Infusions, Parenteral; Injections, Spinal; Male; Muscle Relaxants, Central; Spasticity; Quality of Life; Severity Illness Index; Treatment Outcome
%N 10
%P 652--657
%T Intrathecal baclofen for generalized dystonia.
%V 43
%X The aim of this study was to evaluate the effects of intrathecal bacolfen (ITB) on patients with severe generalized dystonia. Eighty-six participants ranging in age from 3 to 42 years (median age 13 years) with generalized dystonia refractory to oral medications were offered treatment with ITB. Dystonia was associated with cerebral palsy in 71\% of participants. Response to ITB was tested by continuous infusions in 72\%, and by bolus injections in 17\% of participants who had both dystonia and spasticity. Ninety-one percent of participants responded to the screening infusion and 93\% to the bolus injections. Pumps were implanted in 77 participants. Dystonia scores at 3, 6, 12, and 24 months were significantly decreased (p<0.005) compared with baseline scores. Dystonia scores were significantly lower in those with intrathecal catheters positioned at T4, or higher than in those with catheters at T6 or lower (p=0.005). Ninety-two percent of participants implanted with a pump retained their responses to ITB during a median follow-up of 29 months. Patient questionnaires indicated that quality of life and ease of care improved in 86\% and speech improved in 33\%. Side effects of ITB occurred in 26\% of participants. Surgical complications occurred in 38\% and included CSF leaks, infections, and catheter problems. ITB is probably the treatment of choice for generalized dystonia if oral medications are ineffective.
@article{Albright2001,
abstract = {The aim of this study was to evaluate the effects of intrathecal bacolfen (ITB) on patients with severe generalized dystonia. Eighty-six participants ranging in age from 3 to 42 years (median age 13 years) with generalized dystonia refractory to oral medications were offered treatment with ITB. Dystonia was associated with cerebral palsy in 71\% of participants. Response to ITB was tested by continuous infusions in 72\%, and by bolus injections in 17\% of participants who had both dystonia and spasticity. Ninety-one percent of participants responded to the screening infusion and 93\% to the bolus injections. Pumps were implanted in 77 participants. Dystonia scores at 3, 6, 12, and 24 months were significantly decreased (p<0.005) compared with baseline scores. Dystonia scores were significantly lower in those with intrathecal catheters positioned at T4, or higher than in those with catheters at T6 or lower (p=0.005). Ninety-two percent of participants implanted with a pump retained their responses to ITB during a median follow-up of 29 months. Patient questionnaires indicated that quality of life and ease of care improved in 86\% and speech improved in 33\%. Side effects of ITB occurred in 26\% of participants. Surgical complications occurred in 38\% and included CSF leaks, infections, and catheter problems. ITB is probably the treatment of choice for generalized dystonia if oral medications are ineffective.},
added-at = {2014-07-19T17:38:04.000+0200},
author = {Albright, A. L. and Barry, M. J. and Shafton, D. H. and Ferson, S. S.},
biburl = {https://www.bibsonomy.org/bibtex/2702437e73723fe3c7ecc4906d79c929b/ar0berts},
groups = {public},
interhash = {3712bac5ccdb4b3aa5f9b8a146e50297},
intrahash = {702437e73723fe3c7ecc4906d79c929b},
journal = {Dev Med Child Neurol},
keywords = {Adolescent; Adult; Baclofen; Cerebral Palsy; Child; Child, Preschool; Dystonia; Female; Follow-Up Studies; Humans; Infusion Pumps, Implantable; Infusions, Parenteral; Injections, Spinal; Male; Muscle Relaxants, Central; Spasticity; Quality of Life; Severity Illness Index; Treatment Outcome},
month = Oct,
number = 10,
pages = {652--657},
pmid = {11665821},
timestamp = {2014-07-19T17:38:04.000+0200},
title = {Intrathecal baclofen for generalized dystonia.},
username = {ar0berts},
volume = 43,
year = 2001
}