Universität zu Köln

Dressler, D., Berweck, S., Chatzikalfas, A., Ebke, M., Frank, B., Hesse, S., Huber, M., Krauss, J. K., Muecke, K. -H., Nolte, A., Oelmann, H. -D., Schoenle, P. W., Schmutzler, M., Pickenbrock, H., Van der Ven, C., Veelken, N., Vogel, M., Vogt, T. and Saberi, F. Adib (2015). Intrathecal Baclofen therapy in Germany: Proceedings of the IAB-Interdisciplinary Working Group for Movement Disorders Consensus Meeting. J. Neural Transm., 122 (11). S. 1573 - 1580. WIEN: SPRINGER WIEN. ISSN 1435-1463

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Abstract

Continuous intrathecal Baclofen application (ITB) through an intracorporeal pump system is widely used in adults and children with spasticity of spinal and supraspinal origin. Currently, about 1200 new ITB pump systems are implanted in Germany each year. ITB is based on an interdisciplinary approach with neurologists, rehabilitation specialists, paediatricians and neurosurgeons. We are presenting the proceedings of a consensus meeting organised by IAB-Interdisciplinary Working Group for Movement Disorders. The ITB pump system consists of the implantable pump with its drug reservoir, the refill port, an additional side port and a flexible catheter. Non-programmable pumps drive the Baclofen flow by the reservoir pressure. Programmable pumps additionally contain a radiofrequency control unit, an electrical pump and a battery. They have major advantages during the dose-finding phase. ITB doses vary widely between 10 and 2000 mu g/day. For spinal spasticity, they are typically in the order of 100-300 mu g/day. Hereditary spastic paraplegia seems to require particularly low doses, while dystonia and brain injury require particularly high ones. Best effects are documented for tonic paraspasticity of spinal origin and the least effects for phasic muscle hyperactivity disorders of supraspinal origin. Oral antispastics are mainly effective in mild spasticity. Botulinum toxin is most effective in focal spasticity. Myotomies and denervation operations are restricted to selected cases of focal spasticity. Due to its wide-spread distribution within the cerebrospinal fluid, ITB can tackle wide-spread and severe spasticity.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dressler, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Berweck, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chatzikalfas, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ebke, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Frank, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hesse, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Huber, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Krauss, J. K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Muecke, K. -H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nolte, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Oelmann, H. -D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoenle, P. W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmutzler, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pickenbrock, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Van der Ven, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Veelken, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vogel, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vogt, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Saberi, F. Adib UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-388438
DOI:	10.1007/s00702-015-1425-1
Journal or Publication Title:	J. Neural Transm.
Volume:	122
Number:	11
Page Range:	S. 1573 - 1580
Date:	2015
Publisher:	SPRINGER WIEN
Place of Publication:	WIEN
ISSN:	1435-1463
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SPINAL-CORD DISTRIBUTION; CEREBROSPINAL-FLUID; CEREBRAL-PALSY; SPASTICITY; INFUSION; WITHDRAWAL; CATHETER; INDIVIDUALS; BUPIVACAINE; MANAGEMENT Multiple languages Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/38843