Multiple Sclerosis and Baclofen Therapy
Who Is a Candidate for the Intrathecal Baclofen Pump?
Anyone who has spasticity that is not responsive to oral treatment is a candidate. However, intracthecal baclofen therapy (ITB) is more effective for spasticity involving the legs as opposed to the arms.
If you are considering intrathecal baclofen therapy, you will generally meet with a treatment team that may include a doctor specialized in rehabilitation (physiatrist), a physical therapist, an occupational therapist, a nurse, and a social worker. All of these professionals work as a team to provide a comprehensive evaluation of your spasticity symptoms and to establish a treatment plan adapted to your personal needs. Many anesthesiologists who specialize in pain management also manage ITB pumps.
What Are the Advantages of the Baclofen Pump System?
The baclofen pump system:
- Efficiently reduces spasticity and involuntary spasms, promoting a more active lifestyle, better sleep, and reduced need for oral drugs
- Continuously delivers baclofen in small doses directly to the spinal fluid, increasing the therapeutic benefits and causing fewer and less severe side effects than the oral version
- Can be individually adjusted to allow infusion rates that vary over a 24-hour period
- Can be turned off when it isn't needed
- Reduces or eliminates pain and discomfort from spasms and spasticity
What Are the Disadvantages of the Baclofen Pump System?
There are certain risks that must be considered with any surgery, and implanting the baclofen pump is no exception. Risks include:
- An adverse reaction to anesthesia
- Bladder control can be altered, causing loss of urine unexpectedly
- Pump malfunction: If the pump malfunctions (this is rare), it may deliver too much medicine at once. In that instance, you will develop symptoms such as drowsiness, dizziness, weakness, insomnia (difficulty falling and/or staying asleep), lightheadedness, nausea, constipation, vomiting, loose muscles, trouble with vision, coma, respiratory depression, seizures, dry mouth, double vision, decreased concentration, diarrhea, or delayed responsiveness. Should this occur, go to the nearest emergency room immediately. A doctor can give you a drug called physostigmine to counteract baclofen.
- Kinked catheter: If the catheter becomes "kinked," surgery may be necessary to replace the catheter.