Abstract:
:Intrathecal baclofen (ITB) therapy is widely used in the management of spastic hypertonia and dystonia resulting from a multitude of conditions that present with upper motor neuron syndrome signs, such as cerebral palsy, stroke, brain and spinal injuries, and multiple sclerosis. We report successful management of posttraumatic hemiballismus and dystonia with ITB in a 43-yr-old man who sustained a traumatic brain injury secondary to an assault in 1978. He subsequently developed hemiballismus in the right lower limb and dystonia of the distal right upper limb spreading proximally to involve the shoulder. The ballistic movement of the lower limb was severe enough to cause the patient to fall out of his chair and limit his ability to perform activities of daily living safely. He had been on various oral medications and received botulinum toxin and phenol injections, but none alleviated the symptoms. The patient elected to receive the ITB pump. Before ITB, he had an average of 10-12 ballism episodes of the right lower limb per hour. During observed episodes, the right hip would flex up to about 90 degrees, with a fully extended knee. After ITB pump implantation and upward dose titration, the frequency of ballistic right leg movements decreased to about three per day, and the right hip flexed to only 30 degrees. In addition, there was increased ability to isolate individual distal joint movements in the right lower limb. The patient currently receives 202.4 microg/day ITB and continues to benefit almost 6 yrs after ITB pump implantation. This report highlights the emerging role of ITB in managing movement disorders other than dystonia spastic hypertonia and dystonia.
journal_name
Am J Phys Med Rehabiljournal_title
American journal of physical medicine & rehabilitationauthors
Francisco GEdoi
10.1097/01.phm.0000233173.32432.6fsubject
Has Abstractpub_date
2006-09-01 00:00:00pages
779-82issue
9eissn
0894-9115issn
1537-7385pii
00002060-200609000-00010journal_volume
85pub_type
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journal_title:American journal of physical medicine & rehabilitation
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pub_type: 临床试验,杂志文章
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journal_title:American journal of physical medicine & rehabilitation
pub_type: 临床试验,杂志文章
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更新日期:2004-03-01 00:00:00
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