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Intrathecal Baclofen Pump Wean and Risk of Exposure in a Large TBSA Burn Wound Patient: A Case Report.
J Burn Care Res
January 2025
Indiana University, Division of Plastic Surgery, Indianapolis, IN, USA.
Burn injuries in patients with significant pre-existing medical conditions provide unique challenges in both medical management and surgical planning. Spasticity, if left untreated, can be one of the most disabling consequences of a neurologic injury. Treatment is largely dependent on pharmacologic management with anti-spasmodic agents such as baclofen.
View Article and Find Full Text PDFPost-intrathecal chemotherapy-related paraplegia syndrome in hematological cancer patients: A systematic review.
Neurooncol Adv
December 2024
Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
Background: Intrathecal (IT) chemotherapy is essential in treating hematological malignancies, but it can lead to ascending paraplegia, a condition that currently lacks clear management guidelines.
Methods: We conducted a systematic review, analyzing 1219 studies and 116 patients, adhering to PRISMA guidelines for individual patient data. The study, registered under PROSPERO (CRD42022362121), focused on the onset, diagnostic approaches, and therapeutic interventions associated with this complication, and management strategies to tackle the ascending paraplegia.
Optimizing Physical Assessment in Intrathecal Baclofen Screening Trials for High-Performing Patients With Spastic Paraparesis.
Neuromodulation
January 2025
Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Objectives: Intrathecal baclofen (ITB) therapy is well documented as an effective treatment option for severe spasticity. Before ITB implantation, trials are conducted to evaluate efficacy, safety, and candidate suitability. While many centers conduct ITB trials, appropriate physical assessment has not been fully established.
View Article and Find Full Text PDFSafety and efficacy of intrathecal antibodies to Nogo-A in patients with acute cervical spinal cord injury: a randomised, double-blind, multicentre, placebo-controlled, phase 2b trial.
Lancet Neurol
January 2025
Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Background: Spinal cord injury results in permanent neurological impairment and disability due to the absence of spontaneous regeneration. NG101, a recombinant human antibody, neutralises the neurite growth-inhibiting protein Nogo-A, promoting neural repair and motor recovery in animal models of spinal cord injury. We aimed to evaluate the efficacy of intrathecal NG101 on recovery in patients with acute cervical traumatic spinal cord injury.
View Article and Find Full Text PDFIntrathecal Baclofen Pump Refill-Related Cardiac Arrest: A Case Report.
J Pain Palliat Care Pharmacother
November 2024
Department of Pulmonary and Critical Care, Staten Island University Hospital/Northwell Health, Staten Island, NY, USA.
We present the case of a 45-year-old male with a history of multiple sclerosis complicated by spasticity and paraplegia, who developed altered mental status and type II respiratory failure requiring intubation on the same day his intrathecal baclofen pump was refilled by his pain physician. Shortly after admission, the patient experienced cardiac arrest four times within two hours until the pump contents were aspirated, and the patient was stabilized. This case report emphasizes the significance of vigilance and prompt recognition of intrathecal baclofen poisoning, which can lead to life-threatening toxicities and withdrawals.
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