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Severe tardive dystonia: Treatment with continuous intrathecal baclofen administration
Author(s) -
Dressler Dirk,
Oeljeschläger RemtOtto,
Rüther Eckart
Publication year - 1997
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.870120416
Subject(s) - baclofen , dystonia , medicine , anesthesia , tardive dyskinesia , muscle tone , electromyography , muscle relaxant , neurological disorder , physical medicine and rehabilitation , central nervous system disease , surgery , agonist , schizophrenia (object oriented programming) , receptor , psychiatry
Treatment of tardive dystonia with oral baclofen produces ambivalent and overall disappointing results. However, because only a small proportion of the baclofen penetrates into the central nervous system when administered orally, we tested whether it is possible to increase the efficacy of treatment by continuous intrathecal infusion of baclofen (CITB) in a patient with severe tardive axial dystonia unresponsive to conventional therapy. A dose of 100 m̈g/day improved muscle tone, head control, posture, and walking distance; electromyography showed a marked decrease of dystonic muscle activity with fully preserved voluntary muscle activity, and the patient reported substantial reduction of pain. Apart from some minor discomfort at the site of operation, no side effects were noted. Further studies should be encouraged to evaluate the usefulness of CITB for other patients with severe and otherwise untreatable tardive dystonia.