Management of spasticity in multiple sclerosis by intrathecal baclofen

Abstract

Since its introduction, chronic intrathecal baclofen (ITB) infusion has been proved to improve spasticity, spasms and related pain. In the literature, the reported clinical improvement is evident in more than 85% of the patients suffering from spasticity and in more than 66% of the patients suffering from spasms. Usually, the evaluation of spasticity is carried out by the Asworth Scale although there is not yet general accordance on the validity of this scale. It is possible that some of the scales used to assess the implanted patients are not sensitive enough to detect changes in the quality of life or functional outcome. After the pump's implantation, the overall care seems to be rather simple for a devoted team. The side effects are usually temporary but they can worry the patients. The most dangerous side effects are baclofen overdose and withdrawal syndrome. These complications are totally avoidable by adopting an approach attentive to the details regarding the patient, the device, and the procedure.