Pruritus after intrathecal baclofen withdrawal: A retrospective study

Autor: Djamel Ben Smail, C. Hugeron, Bernard Bussel, Pierre Denys
Přispěvatelé: Physiologie et physiopathologie de la motricité chez l'homme, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR70-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Neurological Rehabilitation, Hôpital Raymond Poincaré [AP-HP]
Rok vydání: 2005
Předmět:
Baclofen
MESH: Substance P
medicine.drug_class
MESH: Substance Withdrawal Syndrome
Physical Therapy
Sports Therapy and Rehabilitation
Neurological disorder
Substance P
Central nervous system disease
chemistry.chemical_compound
MESH: GABA Agonists
Drug tolerance
MESH: Injections
Spinal
medicine
Humans
MESH: Incidence
Spasticity
MESH: Pruritus
skin and connective tissue diseases
GABA Agonists
Injections
Spinal
Retrospective Studies
MESH: Humans
MESH: Muscle Spasticity
[SDV.BA.MVSA]Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health
integumentary system
business.industry
Incidence
Pruritus
Rehabilitation
MESH: Retrospective Studies
Retrospective cohort study
Muscle relaxant
Infusion Pumps
Implantable
medicine.disease
Substance Withdrawal Syndrome
MESH: Baclofen
body regions
MESH: Infusion Pumps
Implantable
chemistry
Muscle Spasticity
Anesthesia
medicine.symptom
business
Cohort study
Zdroj: Archives of Physical Medicine and Rehabilitation
Archives of Physical Medicine and Rehabilitation, 2005, 86 (3), pp.494-7. ⟨10.1016/j.apmr.2004.09.001⟩
ISSN: 0003-9993
Popis: Ben Smail D, Hugeron C, Denys P, Bussel B. Pruritus after intrathecal baclofen withdrawal: a retrospective study. Objectives To determine the frequency of pruritus after intrathecal baclofen (ITB) withdrawal and to study the pathophysiology of this symptom. Design Retrospective cohort study. Setting Rehabilitation department of a general hospital. Participants Patients (N=102) implanted with an ITB pump who had been followed up since 1988. Interventions Not applicable. Main outcome measures Incidence of pruritus after withdrawal. We studied the relation between pruritus and daily dose, concentration and mode of infusion of baclofen, and cause of the central nervous system lesion inducing spasticity. Results Pruritus was observed in 10 of 23 cases of ITB withdrawal. It never occurred during the first 3 months after pump implantation. It seems likely that the segmental spinal action of baclofen is responsible for pruritus. There was no statistically significant difference between patients with ITB deprivation who did and did not experience pruritus in their daily infused dosage or in concentration and mode of infusion. Surprisingly, no pruritus was observed in patients with multiple sclerosis. Conclusions Pruritus is a frequent symptom after ITB withdrawal. Its occurrence is probably subsequent to chronic blocking of the liberation of substance P by baclofen at the spinal level. This symptom is a good clinical predictor of baclofen withdrawal, in contrast to an isolated increase of spasticity that may be due to drug tolerance or irritant factors. Pruritus requires investigation of a possible dysfunction of the infusion system.
Databáze: OpenAIRE
Externí odkaz: