Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A double-blind crossover trial against placebo was conducted to assess the effects of the GABA derivative, baclofen, on the disabilities due to muscle spasticity in twenty children suffering from cerebral palsy. Baclofen performed very significantly better than placebo in reducing spasticity and significantly better than placebo in allowing both active and passive limb movements to be carried out. Notable improvement was also seen in scissoring. Side-effects were minimal and responded promptly to dose reduction. The evaluation of drug effects on muscle spasticity and the pharmacodynamics of baclofen are discussed. Recommendations are made regarding dosage of baclogen in childhood.
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PMID:A controlled trial of baclofen in children with cerebral palsy. 33 90

Baclofen is a safe and effective means for treating spasticity associated with multiple sclerosis. We found no toxic effects on hepatologic, hematopoietic, or renal function, acutely or for over 3 years of follow-up. A statistically significant reduction was noted in frequency of spasms, and clonus, and there was improved range of joint movement, which enabled patients to maintain functional status for prolonged periods. For the more disabled patients, treatment with baclofen gave symptomatic relief of painful spasms and made immobility more tolerable. Optimum effect was achieved when baclofen was administered in the early stages of disease, before major disabilities became permanent.
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PMID:Baclofen for spasticity in multiple sclerosis. Double-blind crossover and three-year study. 36 34

Baclofen was used in a double-blind crossover placebo-controlled trial to treat spasticity in patients with multiple sclerosis (MS). While on Baclofen, patients obtained a significant (p less than 0.001) reduction in spasticity compared to controls. The drug was particularly effective in alleviating flexor and extensors spasms, as well as their associated pain. Side effects were common in this study, but were usually well tolerated by the patients. The commonest side effects were sedation, nausea and vomiting. There were no changes in hepatic, renal, or hematological function in any patients. Increase weakness due to loss of spasticity for support was also a fairly common complaint. The drug seems best indicated in patients in whom spasticity is not required for support or other activities of daily living. Careful monitoring of the patient is essential for effective use of this drug.
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PMID:The use of baclofen in treatment of spasticity in multiple sclerosis. 38 32

Baclofen (a gamma aminobutylic acid derivative) and a placebo were compared for their efficacy in relieving certain symptoms in patients with long-standing spinal cord lesions and "spinal spasticity." In a double-blind, cross-over clinical investigation, 22 patients with chronic spinal cord disease were studied. Baclofen regularly alleviated involuntary flexor or extensor spasms and increased resistance to passive movement of the legs but did not alter strength, gait, stretch reflexes, or clonus. Side effects were mild and transient. This study demonstrates that (1) baclofen is useful for the treatment of flexor spasms and (2) in evaluating a new mode of therapy, one must consider selectively the response of individual components of such global syndromes as "spasticity."
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PMID:An evaluation of baclofen treatment for certain symptoms in patients with spinal cord lesions. A double-blind, cross-over study. 77 61

This report summarizes experience with baclofen (Lioresal) in the management of spasticity and muscle spasms in 113 patients treated for up to six years. Baclofen was found to be of little help in nine patients with spasticity of cerebral origin, but was effective in reducing spasticity of spinal origin in 72 out of 90 patients (80%). It also reduced the number and severity of spasms in 76 out of 87 patients (87%). Side effects necessitating reduction of dosage were experienced by 20% of patients. Baclofen appears to be a safe and effective agent in the management of spasticity, with the advantage that adequate dosage can usually be achieved without sedation. Beneficial effects have persisted throughout the follow-up period.
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PMID:Bacloffen (Lioresal) in the long-term management of spasticity. 82 Sep 53

Surface electromyograms were recorded from the quadriceps and hamstring muscles of 11 spastic patients during cyclical flexion and extension movements of the knee. A potentiometer strapped to the knee recorded the angle of the joint, the output signal being displayed on an oscilloscope. The patient used this signal to track a sine wave target for 20 cycles. The observer then moved the patient's limb through a further 20 cycles tracking the same target. Recordings were repeated at intervals for four hours after an oral dose of baclofen. Analysis of the recordings showed that the response of a spastic muscle to lengthening is not the same during passive movement as during voluntary movement. In mild spasticity stretch reflexes appear to be suppressed by voluntary effort whereas in severe spasticity they are enhanced. Baclofen suppressed the response to passive stretch by over 30% at plasma concentrations of over 250 ng/ml and by 50% at concentrations of over 400 ng/ml, but this effect was largely extinguised during voluntary movement.
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PMID:C0-contraction and stretch reflexes in spasticity during treatment with baclofen. 84 4

The author gives a literature review of the management of spasticity carried out. Physical agents used such as ice, heat and vibration are described. Methods used by physical therapists are discussed. Drugs most commonly used in the treatment of spasticity are Diazepam, Baclofen and Dantrolene. Phenol has been used by injection into motor points, peripheral nerves and intrathecally. Other drugs that have been used are also discussed. Neurosurgical procedures include neurectomies, neurotomies, rhizotomies and more radical procedures such as myelotomies and cordectomies. Orthopaedic procedures involve muscle and tendon lengthening, release of contractures and tendon transfers. Surgery is discussed in terms of function. In considering the options, available care must be taken to achieve and maintain optimal functional level.
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PMID:The management of spasticity--a review of options available in rehabilitation. 129 22

Brain injuries are the most frequent cause of handicap in young adults. The success of rehabilitation depends mainly on the avoidance of tertiary lesions of the locomotor system. Between January 1989 and December 1991, 54 patients were treated at the neuro-rehabilitation unit of the Neurology Department of the University Hospital for severe brain injuries. On admission these patients were in different stages of recovery. All patients underwent physiotherapy adapted to their specific needs. The decision as to whether other kinds of treatment were indicated depended on the patients' problems in the recovery phase reached and on the presence or absence of tertiary lesions. In 14 patients, contractures caused by spasticity were successfully treated with plaster casts, which were changed weekly. These contractures were corrected sufficiently. In 5 other patients contractures, also caused by spasticity, were treated with regional anaesthesia administered through an implanted catheter system. In 11 patients a system for continuous intrathecal administration of Baclofen was implanted. Central side effects could be avoided while a lasting decrease of spasticity and hyper-reflexia was achieved. Persisting tertiary lesions, such as contractures, dislocations and spinal deformities, were corrected surgically.
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PMID:[Treatment concepts of tertiary damage of the locomotor system after craniocerebral trauma]. 140 28

Baclofen is a centrally acting muscle relaxant used for treatment of spasticity. Some patients, to experience adequate symptomatic relief, require dosages of baclofen that significantly exceed the conventional 80 mg daily maximum advocated by the 1992 Physicians' Desk Reference. In this pilot study of baclofen kinetics and dynamics in eleven patients, the safety and efficacy of high dose baclofen was confirmed. The data suggest that the pharmacokinetics of high dose baclofen may vary from those described previously. Time-to-peak plasma levels and plasma half-lives were noted to be substantially longer than prior reports indicate. Baclofen blood levels were observed to rise gradually over time in some patients on a stable dosing regimen, probably a result of impaired renal clearance. These findings may indicate that a change in pattern of prescription is warranted and that a reliable and practical measurement of systemic baclofen levels has a useful role in clinical practice, particularly for the patient with neurogenic bladder and potential renal insufficiency.
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PMID:Clinical and pharmacokinetic aspects of high dose oral baclofen therapy. 143 67

In 19 patients, who suffered from severe spinal spasticity of different etiologies and did not respond sufficiently to oral antispastic therapy, intrathecal Baclofen test boli were administered. In 11 patients a DAD (Drug Administration Device) [SynchroMedR Model 8611 H, Medtronic Inc. Minneapolis, USA] was implanted. Catheter dislocation or torsion was the most common complication to be observed in these 11 patients. Long term intrathecal Baclofen application was effective in all patients, as reducing spasticity, flexor spasms and spasm induced pain. In some cases the motor performance ameliorated.
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PMID:Indication, efficiency and complications of intrathecal pump supported baclofen treatment in spinal spasticity. 144 17


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