Continuous intrathecal baclofen therapy in children with cerebral palsy - when does improvement emerge?

Acta Paediatr. 2010 Nov;99(11):1661-5. doi: 10.1111/j.1651-2227.2009.01596.x.

Abstract

Aim: The aim of the study was to explore the timing of effects of intrathecal baclofen therapy in children with cerebral palsy.

Methods: Thirty five children with severe disabilities with cerebral palsy who started continuous intrathecal baclofen therapy (CITB) were followed for 18 months. Pain, number of awakenings during night, spasticity, GMFM-66 scores and PEDI scores were recorded the day before pump implantation and after 6 and 18 months of treatment respectively.

Results: Introduction of CITB was associated with changes across all ICF dimensions. Reduced pain and improved sleep occurred within 6 months of treatment. Social function improved within 6 months and continued to improve until 18 months of CITB. Mobility also improved, but with a latency.

Conclusion: There seems to be a sequence of changes after introduction of continuous intrathecal baclofen in a child with cerebral palsy that may guide the multidisciplinary team in their timing of therapy during post-surgical follow-up.

MeSH terms

  • Adolescent
  • Baclofen / administration & dosage*
  • Cerebral Palsy / drug therapy*
  • Child
  • Child, Preschool
  • Disability Evaluation
  • Disabled Children / rehabilitation*
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Infusion Pumps, Implantable
  • Male
  • Motor Activity
  • Muscle Relaxants, Central / administration & dosage*
  • Muscle Spasticity / drug therapy
  • Pain Measurement
  • Sleep Initiation and Maintenance Disorders
  • Time Factors
  • Treatment Outcome

Substances

  • Muscle Relaxants, Central
  • Baclofen