%0 Journal Article %1 Murphy2002 %A Murphy, Nancy A %A Irwin, Melanie C Nicole %A Hoff, Charles %D 2002 %J Arch Phys Med Rehabil %K Adolescent; Baclofen; Cerebral Palsy; Child; Child, Preschool; Equipment Failure; Female; Humans; Infusion Pumps, Implantable; Injections, Spinal; Male; Muscle Relaxants, Central %N 12 %P 1721--1725 %R 10.1053/apmr.2002.36068 %T Intrathecal baclofen therapy in children with cerebral palsy: efficacy and complications. %U http://dx.doi.org/10.1053/apmr.2002.36068 %V 83 %X OBJECTIVES: To describe the efficacy of intrathecal baclofen (ITB) therapy in the management of spasticity in young children with cerebral palsy (CP) and to identify risk factors for complications. DESIGN: Consecutive case series of 25 implanted ITB delivery systems during a 48-month period. SETTING: Pediatric specialty hospital and outpatient department. PARTICIPANTS: Twenty-three children (age range, 4.5-17.4y) with CP (spastic diplegia in 22\%; spastic quadriplegia in 61\%; mixed-type diplegia in 4\%; mixed-type quadriplegia in 13\%). INTERVENTION: Intrathecal baclofen therapy in children with cerebral palsy. MAIN OUTCOME MEASURES: Ashworth Scale scores before treatment and at 6 and 12 months after ITB therapy; frequency and nature of complications; and relation between patient characteristics and outcomes. RESULTS: Average Ashworth scores +/- standard deviation decreased from 3.26+/-.73 to 2.34+/-.83 (P<or=.01) in the lower extremities and from 2.69+/-.79 to 2.00+/-.55 (P<or=.05) in the upper extremities 6 months after ITB therapy and remained comparably decreased at 12 months. Explantation was required in 44\% (11/25), with wound complications as the leading cause in 73\% (8/11). Complications were associated with the diagnosis of mixed-type CP, as compared with pure spastic types (P<or=.01). Trends suggest that children of smaller size and younger age, as well as those with gastrostomy tubes and nonambulatory status, were more likely to encounter complications necessitating explantation. CONCLUSION: ITB therapy effectively reduced spasticity in children with CP. However, complications necessitating explantation can occur. Further research is needed to identify criteria describing the ideal pediatric candidate for ITB.

@article{Murphy2002, abstract = {OBJECTIVES: To describe the efficacy of intrathecal baclofen (ITB) therapy in the management of spasticity in young children with cerebral palsy (CP) and to identify risk factors for complications. DESIGN: Consecutive case series of 25 implanted ITB delivery systems during a 48-month period. SETTING: Pediatric specialty hospital and outpatient department. PARTICIPANTS: Twenty-three children (age range, 4.5-17.4y) with CP (spastic diplegia in 22\%; spastic quadriplegia in 61\%; mixed-type diplegia in 4\%; mixed-type quadriplegia in 13\%). INTERVENTION: Intrathecal baclofen therapy in children with cerebral palsy. MAIN OUTCOME MEASURES: Ashworth Scale scores before treatment and at 6 and 12 months after ITB therapy; frequency and nature of complications; and relation between patient characteristics and outcomes. RESULTS: Average Ashworth scores +/- standard deviation decreased from 3.26+/-.73 to 2.34+/-.83 (P<or=.01) in the lower extremities and from 2.69+/-.79 to 2.00+/-.55 (P<or=.05) in the upper extremities 6 months after ITB therapy and remained comparably decreased at 12 months. Explantation was required in 44\% (11/25), with wound complications as the leading cause in 73\% (8/11). Complications were associated with the diagnosis of mixed-type CP, as compared with pure spastic types (P<or=.01). Trends suggest that children of smaller size and younger age, as well as those with gastrostomy tubes and nonambulatory status, were more likely to encounter complications necessitating explantation. CONCLUSION: ITB therapy effectively reduced spasticity in children with CP. However, complications necessitating explantation can occur. Further research is needed to identify criteria describing the ideal pediatric candidate for ITB.}, added-at = {2014-07-19T20:49:36.000+0200}, author = {Murphy, Nancy A and Irwin, Melanie C Nicole and Hoff, Charles}, biburl = {https://www.bibsonomy.org/bibtex/2ca2d8c58f1eecd6cefca6400e85d2812/ar0berts}, doi = {10.1053/apmr.2002.36068}, groups = {public}, interhash = {fc81df390fe2d12eec5dc92e93df6c58}, intrahash = {ca2d8c58f1eecd6cefca6400e85d2812}, journal = {Arch Phys Med Rehabil}, keywords = {Adolescent; Baclofen; Cerebral Palsy; Child; Child, Preschool; Equipment Failure; Female; Humans; Infusion Pumps, Implantable; Injections, Spinal; Male; Muscle Relaxants, Central}, month = Dec, number = 12, pages = {1721--1725}, pii = {S0003999302005920}, pmid = {12474176}, timestamp = {2014-07-19T20:49:36.000+0200}, title = {Intrathecal baclofen therapy in children with cerebral palsy: efficacy and complications.}, url = {http://dx.doi.org/10.1053/apmr.2002.36068}, username = {ar0berts}, volume = 83, year = 2002 }