ORIGINAL ARTICLES   

Journal of Neurosurgical Sciences 2004 December;48(4):177-81

Copyright © 2005 EDIZIONI MINERVA MEDICA

lingua: Inglese

Pharmacological complications of the chronic baclofen infusion in the severe spinal spasticity. Personal experience and review of the literature

Dario A., Scamoni C., Picano M., Casagrande F., Tomei G.

Neurosurgical Clinic, University of Insubria University Hospital of Varese, Varese, Italy

Aim. To evaluate the pharmacological complications and side effects of the chronic intrathecal baclofen infusion in patients suffering from intractable spinal spasticity in our Department as well as in the literature.
Methods. The pharmacological complications and side effects observed at long-term follow-up in 25 patients with chronic intrathecal baclofen infusion are evaluated; the search of the literature complications was carried out in Medline and in Ingenta web sites.
Results. We have been able to observe in our series 3 (12%) patients with hypotonia, 2 with impairment on erection (8%) and 1 (4%) with constipation; 5 (20%) patients showed also tolerance but only 1 (4%) needed a “drug holiday”. In the literature the side effects range from 4% to 16%. Moreover the tolerance is reported from 3% to 15%. The overdose has been reported from 0% to 14%, while the syndrome of withdrawal is reported in 16 patients with 6 fatalities. In our series these two last complications were not observed.
Conclusion. Lethal pharmacological complications are rare and, if promptly diagnosed and treated, are reversible. Side effects of minor importance can impair the patient quality of live and needed to be adjusted to patient’s requirements. This kind of therapy should be restricted to specialized centres.