Bomba de baclofén intratecal en el tratamiento a largo plazo de las distonías generalizadas

Abstract

Much has been written in the literature about the use of intrathecal baclofen in an infusion pump in spasticity, but it has only recently been applied to cases of dystonia. The purpose of this study was to determine whether intrathecal baclofen is a therapeutic option in patients with a long history of generalised dystonias who have failed to respond to conventional treatment. We conducted a prospective study involving five patients from whom the following data were collected: age, sex, time since the onset of dystonia and the type of dystonia. They were also chosen because they had failed to respond to any kind of treatment, including oral baclofen, but had experienced a clinical improvement following the administration of baclofen by means of a spinal tap in progressive 25, 50, 75 and 100 mg boluses. The Burke-Fahn-Marsden scale was used before and after implanting the pump to evaluate functional capacity. Of the five patients, one improved remarkably to the point of being able to lead a normal life; three others showed marked improvements, although they are still to some extent limited when it comes to carrying out certain basic activities; and in the case of the third female patient the pump had to be withdrawn due to the absence of any kind of response. Intrathecal baclofen is a therapy that has only recently been introduced but these results allow us to state that it does bring about an improvement in the symptoms of patients with a long history of dystonia in whom conventional treatment has failed.