Intrathecal baclofen therapy to spasticity]

Intrathecal baclofen injection (ITB) has been available since April, 2006 in Japan. According to the clinical trial data, ITB reduced continuously the average Ashworth spasticity score (1 no spasticity-5 completely contracted) from 3.85 to 1.84 or below as well as the average spasm score (0 no spasm-4 more than 10 spasms hour) from 2.56 to 0.75. It also reduced the number of patients with severe pain from 45% to 17% as well as the number of patients with severe compressive sensation from 65% to 11%. The effect was very dramatic and there have been no severe side effect. ITB seems effective and useful to patients suffered from marked spasticity. It appears also safe when appropriate patients are selected and careful procedures are taken. Because ITB needs surgical procedures, neurosurgeon or orthopedic surgeons have been involved so far. We neurologist, however, should at least know about ITB and its powerful effect against severe spasticity while we must be aware of dangerous situation due to overdose and secession of the baclofen.