About Stroke
As the number one cause of disability in adults, stroke affects a diverse range of people. If you are one of them, you know stroke may cause severe spasticity. You should also know it's possible to manage your symptoms and live more comfortably – with a device developed by Medtronic.
Definition
A stroke occurs when a blood clot blocks a blood vessel or artery. It also can occur when a blood vessel breaks, interrupting blood flow to an area of the brain. A stroke kills brain cells in the immediate area.
When brain cells die during a stroke, abilities controlled by that area of the brain are lost. These abilities may include speech, movement, and memory. The way a stroke affects you depends on where the stroke occurs in the brain and how much of the brain is damaged.1
Causes
An ischemic stroke is the most common kind of stroke. It's caused by a blood clot that blocks or plugs a blood vessel in the brain. A hemorrhagic stroke is caused by a blood vessel that breaks and bleeds into the brain. "Mini-strokes," or transient ischemic attacks (TIAs), happen when the blood supply to the brain is briefly interrupted.2
Risk Factors
A stroke can happen to anyone. However, you can control or treat many major risk factors, including:3
- High blood pressure
- Cigarette smoking
- Heart disease
- Diabetes
- TIA
Risk factors you can't control include:1
- Being over age 55
- Being male
- Being African American, Hispanic or Asian/Pacific Islander
- Having a family history of stroke
Symptoms
Symptoms of stroke come on suddenly, and may include:3
- Numbness or weakness of the face, arm or leg (especially on one side of the body)
- Confusion, trouble speaking or understanding speech
- Trouble seeing in one or both eyes
- Trouble walking, dizziness, loss of balance or coordination
- Severe headache with no known cause
Diagnosis
The following screening tools are most often used to determine stroke risk, but they also can be used to diagnose stroke:4
- Physical examination
- Basic laboratory tests
- Specialized tests, which may include CT Scan, computed tomographic angiography (CTA), magnetic resonance imaging (MRI), and electrocardiogram (ECG), an ultrasound of the heart
About Spasticity due to Stroke
If you've suffered a stroke, you may begin to experience spasticity.
Spasticity is caused by damage or injury to the part of the central nervous system (the brain or spinal cord) that controls voluntary movement. This damage disrupts important signals between the nervous system and muscles, creating an imbalance that increases muscle activity or spasms.
Spasticity can make movement, posture, and balance difficult. It may affect your ability to move one or more of your limbs, or to move one side of your body. Sometimes spasticity is so severe that it gets in the way of daily activities, sleep patterns, and care giving. In certain situations, this loss of control can be dangerous for the individual.
References
- National Stroke Association. What is Stroke. Available at: www.stroke.org. Accessed 04/04/08.
- Medline Plus. Stroke. Available at: www.nlm.nih.gov. Accessed 04/04/08.
- National Institute of Neurological Disorders and Stroke. Risk Factors for a Stroke. Available at: www.ninds.nih.gov. Accessed 04/04/08.
- Mayo Clinic. Stroke. Available at: www.mayoclinic.org. Accessed 04/04/08.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call
Safety Information – 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, traumatic 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, respiratory depression (difficulty breathing), 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 Novartis Pharmaceuticals Corporation.
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.
Last updated: 3 Aug 2008
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