Management of severe spasticity with and without dystonia with intrathecal baclofen in the pediatric population:a cross-sectional study  

作　　者：Joslyn Gober Michelle Seymour Hongyu Miao Daniel J.Curry Sruthi P.Thomas 

机构地区：[1]Department of Physical Medicine and Rehabilitation,University of Miami Miller School of Medicine,Miami,Florida,USA [2]Department of Physical Medicine and Rehabilitation,Baylor College of Medicine,Houston,Texas,USA [3]Department of Biostatistics and Data Science,The University of Texas Health Science Center at Houston,Houston,Texas,USA [4]Department of Neurosurgery,Baylor College of Medicine,Houston,Texas,USA

出　　处：《World Journal of Pediatric Surgery》2022年第3期119-124,共6页世界小儿外科杂志（英文）

摘　　要：Objective To investigate the differences in delivery mode,daily dose,and catheter tip location in pediatric patients using intrathecal baclofen(ITB)pumps with spasticity plus dystonia versus spasticity alone.Methods A single-center,cross-sectional study was performed by collecting retrospective data from electronic medical records.Demographic and diagnostic information was obtained,comparing patients with spasticity with or without dystonia.The data were analyzed for group differences using a two-tailed Student’s t-test.Categorical data were analyzed for group differences using Pearson’s χ^(2) test.Results A total of 137 patients met the criteria.The majority(114)had spasticity plus dystonia whereas only 23 were documented as spasticity alone.Simple continuous dosing was the most common delivery mode,but flex dosing was used more than twice as frequently with spasticity plus dystonia compared with spasticity alone(42%vs 17%).Patients with spasticity plus dystonia also had more rostral catheter tip locations.Conclusions While it has been discussed anecdotally,this study confirms the supposition that patients with spasticity plus dystonia have increased dose requirements when compared with those with spasticity alone.Although there are no clear standards of care when managing these patients,they are often on higher daily dosages,are more likely to require flexed dosing method,and have higher catheter placements.Still,there are few studies that demonstrate improvements in dystonia with the use of ITB.In general,these patients would benefit from the development of universal standardizations as well as the confirmation that this is an appropriate treatment.

关 键 词：DOSAGE ALONE sectional 

分 类 号：R726[医药卫生—儿科]