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Intrathecal baclofen in dyskinetic cerebral palsy: effects on function and activity
Author(s) -
Eek Meta N,
Olsson Kristina,
Lindh Karin,
Askljung Berit,
Påhlman Magnus,
Corneliusson Olle,
Himmelmann Kate
Publication year - 2018
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13625
Subject(s) - cerebral palsy , baclofen , intrathecal , physical medicine and rehabilitation , medicine , neuroscience , anesthesia , psychology , agonist , receptor
Aim To investigate the effect of intrathecal baclofen ( ITB ) on function and activity in dyskinetic cerebral palsy ( CP ). Method A retrospective cohort study of records from 25 children (15 males, 10 females; mean age 10y 11mo, SD 4y 9mo). Five were classified in Gross Motor Function Classification level IV and 20 in level V. Parents were interviewed about activities in daily life, sitting, communication, pain, sleep, and gross and fine motor function. Differences before and 1 year after ITB were graded as positive, no change, or negative. Assessments of dystonia (using the Barry–Albright Dystonia Scale) and muscle tone (Ashworth Scale) were made. Joint range of motion ( ROM ) was measured. Results Both dystonia and increased muscle tone, present in all participants before ITB , decreased after ( p <0.001). Passive ROM was restricted, with no difference after. Parents reported improvements in activities in daily life ( p <0.001), sitting ( p <0.001), communication ( p <0.001), and fine motor function ( p =0.013), but no change in gross motor function. Before ITB , pain and disturbed sleep were reported. There was a reduction in pain ( p =0.002) and sleep improved ( p =0.004) after ITB . Interpretation After ITB in individuals with dyskinetic CP , improvements were found in sitting, communication, and fine motor skills. There was a reduction in dystonia and muscle tone, and pain and sleep improved. What this paper adds Intrathecal baclofen can affect specific aspects of functioning in dyskinetic cerebral palsy. Sitting, communication, and fine motor function improved. Dystonia and spasticity were reduced. Pain was reduced and sleep improved.