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Use of intrathecal baclofen for treatment of spasticity in amyotrophic lateral sclerosis
  1. G Marquardt,
  2. V Seifert
  1. Neurosurgical Clinic, Johann Wolfgang Goethe-University, Schleusenweg 2–16, 60528 Frankfurt am Main, Germany
  1. Correspondence to:
    Dr G Marquardt;
    G.Marquardt{at}em.uni-frankfurt.de

https://doi.org/10.1136/jnnp.72.2.275

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    Baclofen, an agonist of γ-amino butyric acid, is one of the most effective drugs in the treatment of spastic movement disorders. However, higher oral dosages required for sufficient spasticity control are related to intolerable central side effects. In this situation, continuous intrathecal application of baclofen in microgram dosages has proved its efficacy in numerous series of patients with spasticity of cerebral or spinal origin.1–,3 Nevertheless, the use of intrathecally administered baclofen in amyotrophic lateral sclerosis, representing the most common degenerative motor neuron disease in adult life,4 has been mentioned in only one short communication.5 In this context our experience with intrathecal baclofen therapy is worth presenting. These two patients are the only ones we have treated in this manner and both experienced a marked improvement in their quality of life.

    Patient 1, a 25 year old man, was previously reported in brief 5; he is still alive and benefiting from intrathecal baclofen therapy. Five years ago he noticed progressive gait disturbance, weakness of his right foot, and painful nocturnal cramps in his legs. At that time he exhibited neurologically mild pareses of his right hand and foot, generalised fasciculations, and spasticity. Amyotrophic lateral sclerosis was diagnosed and oral …

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