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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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REVIEWS  UPPER MOTOR NEURON SYNDROME: EVALUATION AND TREATMENT OF SPASTICITY
Guest Editor: FRANCO MOLTENI


Europa Medicophysica 2004 June;40(2):131-43

language: English

The role of intrathecal baclofen therapy in the upper motor neuron syndrome

Francisco G. E.

1 Physical Medicine and Rehabilitation University of Texas Health Sciences Center Houston, TX, USA
2 Physical Medicine and Rehabilitation Baylor College of Medicine, Houston, TX, USA
3 Research Services, Brain Injury and Stroke Program Institute for Rehabilitation and Research, Houston, TX, USA


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This ­review arti­cle ­will dis­cuss the appli­ca­tion of intra­the­cal baclof­en (ITB) ther­a­py in the ­upper ­motor neu­ron syn­drome (­UMNS). While the ­UMNS con­sists of a varie­ty of ­signs and symp­toms, spas­tic­ity ­appears to be the ­most wide­ly dis­cussed in ­research and clin­i­cal prac­tice. Thus, ­while a varie­ty of ­motor dis­or­ders ­result ­from spas­tic­ity and the oth­er com­po­nents of the ­UMNS, ­such as dys­to­nia, rigid­ity, and co-con­trac­tion of ago­nists and antag­o­nists, we ­will ­refer to spas­tic­ity as the rep­re­sen­ta­tive pathol­o­gy of the ­UMNS. The ­term spas­tic­ity ­will be ­used in ­this dis­cus­sion as if it ­were syn­on­y­mous to the ­UMNS, ­because it is the ­term ­used in ­most pub­lished ­research and ­papers. This ­does not nec­es­sar­i­ly ­mean ­that the oth­er fea­tures of the ­UMNS are ­less impor­tant. Publications in the use of ITB in the pedi­at­ric pop­u­la­tion, espe­cial­ly cere­bral pal­sy, ­abound, but ­this ­paper ­will ­focus on ­UMNS in ­adults. In addi­tion to review­ing the pro­cess of ITB man­age­ment, ­from ­patient selec­tion to reha­bil­i­ta­tion, top­ics of prac­ti­cal inter­est to cli­ni­cians ­will be dis­cussed.

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