Abstract
1. IntroductionMultiple Sclerosis (MS) is a neurodegenerative dis-order which affects around 100,000 people in the UK.It is relatively rare but important clinically as typicalonset is in young adulthood and it can result in severeand progressive disability.The development of spasticity is a common compli-cationamongstMSsufferersandisalsoaprimarycauseof morbidity. In many patients the degree of spasticityprogresses to the point where function is significantlyimpaired. In addition painful muscle spasms can de-velop and are a major source of discomfort and furtherdisability.Management of spasticity in MS patients is mostcommonly with oral Baclofen, a GABA receptor ago-nist. However, it has poor lipid solubility and does notreadilycross the blood-brainbarrier, necessitatinghighdoses and the consequential side effects. When spas-ticity cannot be sufficiently controlled by oral therapy,intrathecalBaclofen (ITB) administrationis an alterna-tive which many patients are eager to take up.Management of spasticity with ITB was first de-scribed in 1984 by Penn and Kroin and has become
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