Effect of Intrathecal baclofen, botulinum toxin type A and a rehabilitation programme on Locomotor function after spinal cord injury: A case report
Abstract
OBJECTIVE: A few studies have reported the use of botulinum toxin injections after spinal cord injury, as this is the gold standard to treat focal spasticity. We report such a case here. CASE REPORT: A 38-year-old woman who had become paraplegic and care-dependent secondary to cervico-thoracic intramedullary ependymoma, presented 8 months later with painful lower limb spasticity, which was being treated with oral anti-spastic and benzodiazepine drugs with no therapeutic effect. We treated the patient with intrathecal baclofen to reduce her spasticity and in order to avoid the major side-effects of high dosages of oral baclofen. After motor rehabilitation programmes, which included functional electrical stimulation, the patient was able to wear an advanced reciprocating gait orthosis. However, she experienced painful muscle spasms in her toes of the feet that limited her gait. Therefore, she was also treated with bilateral injections of botulinum toxin type A into the flexor digitorum brevis muscles. The patient reported relief of spasms and pain, enabling her to wear an advanced reciprocating gait orthosis and facilitating rehabilitation programmes. CONCLUSION: The use of botulinum toxin type A may be an important adjunctive therapy to increase the therapeutic effect of baclofen on spasticity in small muscles, resulting in a more focal effect, and improving the use of orthoses and the effectiveness of rehabilitation programmes in patients after spinal cord injury.
Autore Pugliese
Tutti gli autori
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RANIERI M.;FIORE P.;SOLFRIZZI V.
Titolo volume/Rivista
Non Disponibile
Anno di pubblicazione
2010
ISSN
1650-1977
ISBN
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Numero di citazioni Wos
Nessuna citazione
Ultimo Aggiornamento Citazioni
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Numero di citazioni Scopus
10
Ultimo Aggiornamento Citazioni
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Settori ERC
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Codici ASJC
Non Disponibile
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