Affiliations: [a] Department of Physical Medicine and Rehabilitation, University of California, Irvine, Orange, CA, USA
| [b] Department of Pediatric Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| [c] Department of Neurosurgery, Miller’s Children’s and Women’s Hospital, Long Beach, CA, USA
| [d] Department of Pediatric Rehabilitation, Miller’s Children’s and Women’s Hospital, Long Beach, CA, USA
Correspondence:
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Corresponding author: Jennifer Wu, Department of Pediatric Rehabilitation, Spaulding Rehabilitation Hospital, 300 First Avenue, Charlestown, MA 02129, USA. Tel.: +1 6179525800; E-mail: Jennifer.Wu@childrens.harvard.edu.
Abstract: PURPOSE:The aim of the study was to evaluate the use of a novel technique for baclofen delivery using an intrathecal catheter inserted through a lumbar laminotomy with the tip placed at the cisterna magna (supraspinal baclofen (SSB)) for the treatment of severe generalized secondary dystonia. METHODS:A cohort study of six individuals (4M/2F, mean±SD = 15±4.86 years) with generalized dystonia unresponsive to oral medications were treated with SSB and followed clinically for 9 years. Intrathecal catheter tips were positioned under fluoroscopic guidance just above the level of the foramen magnum, at the cisterna magna. RESULTS:Five of the 6 patients experienced sustained benefit with SSB; the group mean modified Fahn-Marsden scale scores decreased from 95 to 55 (t = 3.29, p = 0.02). One patient suffered complex pump pocket infection, and therefore underwent pump explantation. CONCLUSION:Supraspinal baclofen may be an effective method for infusing baclofen into the ventricular system of the brain for treatment of secondary dystonia which is unresponsive to oral therapy.
