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Careful Consideration Should Be Preceded Before Intrathecal Baclofen Pump Implantation in a Patient with Amyotrophic Lateral Sclerosis: A Case Report

Other Titles
 근위축성 측삭 경화증 환자에서 경막내 바클로펜 펌프 삽입술 전 고려 사항: 증례보고 
 Su Ji Lee  ;  Tae Yong Kim  ;  Won Seok Chang  ;  Sung-Rae Cho 
 Geriatric Rehabilitation, Vol.11(2) : 115-120, 2021-09 
Journal Title
Geriatric Rehabilitation
Issue Date
Amyotrophic lateral sclerosis ; Intrathecal injection ; Baclofen
Amyotrophic Lateral Sclerosis (ALS) is characterized by progressive degeneration of both upper and lower motor neurons. Predominant upper motor neuron involvement causes clinical manifestations of spasticity. We report a case of ALS presenting progressive spastic paraplegia treated with intrathecal baclofen (ITB) test trials before ITB pump implantation. Electrodiagnostic studies confirmed the diagnosis of ALS. After administration of 50 mcg and 25 mcg of ITB separately, severe spasticity of both legs was relieved effectively within 2 hours after a ITB test trial. However, weakness of both lower extremities appeared which eventually led to functional decline in the item “turning in bed and adjusting bed clothes” of the ALS Functional Rating Scale-Revised. Desaturation event also occurred four hours after 50 mcg ITB bolus injection. Therefore, careful consideration is necessary for in a patient with ALS presenting spastic paraplegia before ITB pump implantation. In particular, ITB test trial should be preceded when considering ITB pump implantation.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Cho, Sung-Rae(조성래) ORCID logo https://orcid.org/0000-0003-1429-2684
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