Intrathecal baclofen therapy for severe spasticity in an adult with tethered cord syndrome: a case report
| Autor: | Hiroyuki Hayashi, Yoshiyuki Kitano, Aki Nakanami, Kenji Kagechika, Tetsutaro Yahata, Satoshi Kidani, Kazu Toyooka, Hiroshi Yamada, Hiroyuki Tsuchiya, Hidehumi Ebara, Yuji Ishino, Yasutaka Takagi |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Baclofen medicine.medical_treatment Case Report Intrathecal chemistry.chemical_compound Pharmacotherapy medicine Humans Spasticity Neural Tube Defects Tethered cord syndrome Tethered Cord Injections Spinal Intrathecal infusion Rehabilitation business.industry Muscle Relaxants Central musculoskeletal neural and ocular physiology Infant Newborn General Medicine Infusion Pumps Implantable Middle Aged Intrathecal baclofen chemistry nervous system Muscle Spasticity Anesthesia Medicine Female medicine.symptom business Lumbosacral joint |
| Zdroj: | Journal of Medical Case Reports Journal of Medical Case Reports, Vol 15, Iss 1, Pp 1-5 (2021) |
| ISSN: | 1752-1947 |
| Popis: | Background Patients with tethered cord syndrome often suffer severe spasticity. To the best of our knowledge, intrathecal baclofen (ITB) therapy in a patient with tethered cord syndrome has not been reported previously. We describe a case in which ITB therapy was useful for treating severe spasticity in an adult with tethered cord syndrome. Case presentation We present the case of a 50-year-old Japanese woman with tethered cord syndrome and related conditions suffering from severe spasticity and pain in the lower limbs. She was born with a lumbosacral myelomeningocele, which was closed in the neonatal period. For 4–5 years before this presentation, spasticity in the lower limbs had been exacerbated without any obvious cause. She received rehabilitation and pharmacotherapy from a local doctor, but symptoms were unimproved, and her previous doctor referred her to this department. A test with 50 μg of intrathecally delivered baclofen showed total relief of spasticity and pain, so a pump was implanted for continuous baclofen delivery. During 24 months of follow-up, spasticity has remained under excellent control with baclofen at 38.5–41.0 μg/day. Conclusions ITB therapy proved extremely effective in this adult with severe spasticity from tethered code syndrome. |
| Databáze: | OpenAIRE |
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