Treatment Options for Severe Spasticity
People with spasticity can treat their condition in many ways: rehabilitation, medication, injection therapy, even surgery. There is also Medtronic ITB TherapySM (Intrathecal Baclofen Therapy), also called the baclofen pump, which may be helpful for reducing your severe spasticity.
There is currently no cure for severe spasticity. However, there are a number of treatment options available for managing your symptoms. They include:
Rehabilitation Therapy
Rehabilitation therapy usually takes place in a clinic, a hospital, or at home. It can include any combination of physical, occupational, or speech therapy.
Oral Medication
Oral medications may help some people treat the symptoms of spasticity.
Neurosurgeries
Neurodestructive surgical procedures include selective dorsal rhizotomy, in which the dorsal (sensory) nerve roots are severed.
Injection Therapy
Injection therapy is usually intended for specific muscle groups (for example, one hand, one foot, one shoulder).
Orthopedic Surgery
Orthopedic surgeries include soft tissue procedures like tendon transfers and osteotomies (cutting a bone to change its alignment).
ITB Therapy (Baclofen Pump)
Medtronic ITB Therapy, also called the baclofen pump, is an adjustable, reversible treatment for severe spasticity. A surgically placed pump and catheter deliver liquid baclofen (Lioresal® Intrathecal) directly to the fluid around the spinal cord, where it’s needed most.
Tools to Identify Spasticity Patterns
Download tools to record information that will help you and your physician determine how your symptoms can be most effectively treated.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call
IMPORTANT SAFETY INFORMATION ON ITB THERAPY
Please follow your doctor's instruction closely because a sudden stop of intrathecal baclofen therapy can result in serious illness (baclofen withdrawal symptoms) such as high fever, changed mental status, muscle rigidity, and in rare cases multiple organ-system failure and death. It is very important that your doctor be called right away if you experience any of the above symptoms.
It is important for you to keep your scheduled refill visits so you don't run out of medication (baclofen) and to understand the early symptoms of baclofen withdrawal. Some patients are at more risk than others for baclofen withdrawal; consult with your doctor.
People who suffer from severe spasticity resulting from cerebral palsy, multiple sclerosis, stroke, brain injury, or spinal cord injury may be a candidate for ITB Therapy. If you have spasticity due to spinal cord injury or multiple sclerosis you must first fail oral baclofen. If you have experienced a traumatic brain injury you must first wait 1 year after the injury to be considered for ITB Therapy. A screening test will help show if you will respond to the intrathecal baclofen. You should not receive ITB Therapy if you have an infection, are allergic to baclofen, or your body size is too small to hold the implantable pump.
The implanted pump and catheter are surgically placed beneath the skin. Surgical complications that you may experience include infection, meningitis, spinal fluid leak, paralysis, headache, swelling, bleeding, and bruising.
The most common and/or serious drug-related side effects of ITB Therapy include loose muscles, sleepiness, upset stomach, vomiting, headaches, and dizziness. Pump failure may cause overdose or underdose of intrathecal baclofen. The signs and symptoms of overdose include drowsiness, lightheadedness, dizziness, respiratory depression (difficulty breathing), hypothermia, seizures, loss of consciousness, and coma. Once the infusion system is implanted, device complications include catheter or pump moving within the body or eroding through the skin. The catheter could leak, tear, kink, or become disconnected, resulting in underdose or no baclofen infusion. Symptoms of underdose include increase or return in spasticity, itching, low blood pressure, lightheadedness, and tingling sensation. These symptoms are often early indications of baclofen withdrawal. The pump could stop because the battery has run out or because of component failure. The pump will sound an alarm when the pump needs to be filled with baclofen, replaced or if there is a problem with the pump. Always inform any healthcare personnel that you have an implanted infusion system before any medical or diagnostic procedure such as MRI or diathermy.
For more information, please read the Lioresal® Intrathecal (baclofen injection) Full Prescribing Information and the SynchroMed Infusion System Information.
This therapy is not for everyone. Please contact your doctor. A prescription is required.
Lioresal® is a registered trademark of Medtronic, Inc.
USA Rx Only Rev 0911
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
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