Treatment OptionS

TREATMENT OPTIONS

CONVENTIONAL TREATMENTS

Oral medication

PHYSICAL THERAPY
With phyiotherapy, ergotherapy and logopaedics, you can train your brain to relearn some abilities. Use alone or alongside conventional and advanced treatments.

Oral medication

ORAL MEDICATION
Oral medication can lower the burden caused by spasticity. For severe disabling spasticity, oral medication should be used at high dosage, which can cause intolerable side effects. Used until not effective any more or creates intolerable side effects.1

ADVANCED TREATMENTS

Oral medication

INJECTIONS
Injection of neurolytic agents (phenol and alcohol). Spasticity can also be treated with botulinum toxin injections. This is a neurotoxin that interferes with muscle contraction process and can reduce muscle tone for about 3 months2. Generally used for focal spasticity, i.e. in one limb only.

Oral medication

SURGERY
Surgical interventions (e.g. tendon lengthening or transfer) can be applied to affected muscles or if contractions occur. Irreversible procedures to treat spasticity include neuroctomy, myeloctomy and rhizotomy.

Oral medication

INTRATHECAL BACLOFEN THERAPY
If the spasticity affects more than one extremity and you have already tried other treatment options without a satisfying effect or with too many side effects, then intrathecal baclofen therapy can help you to lower the burden caused by spasticity and increase your function and quality of life.3-4

Treatment options can be combined to reach the best possible outcome

WHAT IS INTRATHECAL BACLOFEN THERAPY?

From theory to practice

HOW DOES INTRATHECAL BACLOFEN THERAPY WORK?

One important advantage of ITB therapySM is that you can try if it works for you before the pump is implanted.

A standard test dose (screening test) determines if ITB therapySM could work for you.

A small quantity of liquid medication is injected directly to the fluid around the spinal cord using a syringe.

Timeline of stroke treatment

more than 9 out of 10 patients respond positively to the test dose.3,6,7,8,9

Doctor Icon

A standard test dose (screening test) determines if ITB therapySM could work for you. A small quantity of liquid medication is injected directly to the fluid around the spinal cord using a syringe. Your medical team will carefully monitor and assess what effect the medication is having on you. If you and your medical team decide ITB therapySM is right for you, a programmable drug infusion system will be implanted under your skin for long-term management of your spasticity symptoms.

1

Ertzgaard P, Campo C, Calabrese A. Efficacy and safety of oral baclofen in the management of spasticity: A rationale for intrathecal baclofen. J Rehabil Med. 2017;49:193–203

2

Elia AE et al. Botulinum neurotoxins for post-stroke spasticity in adults: a systematic review. Mov Disord. 2009 Apr 30;24(6):801-1

3

Ivanhoe CB, Francisco GE, McGuire JR, et al. Intrathecal baclofen management of poststroke spastic hypertonia: implications for function and quality of life. Arch Phys Med Rehabil. 2006;87(11):1509–15

4

Schiess MC, Oh IJ, Stimming EF, et al. Prospective 12-month study of intrathecal baclofen therapy for poststroke spastic upper and lower extremity motor control and functional improvement. Neuromodulation. 2011;14(1):38-45

5

Barnes MP, Johnson GR. Upper motor neurone syndrome and spasticity: Clinical management and neurophysiology: Cambridge University Press. 2008

6

Penn RD. Intrathecal baclofen for spasticity of spinal origin: seven years of experience. J  Neurosurg. 1992;77(2):236–40

7

Meythaler JM, Guin-Renfroe S, Law C, et al. Continuously infused intrathecal baclofen over 12 months for spastic hypertonia in adolescents. Arch Phys Med Rehabil. 200;82(2):155–61

8

Coffey RJ, et al. Intrathecal baclofen for intractable spasticity of spinal origin: results of a long-term multicenter study. J Neurosurg. 1993;78:226–32

9

Gilmartin R, Bruce D, Stoors 88, et al. lntrathecal baclofen for management of spastic cerebral palsy: multicenter trial. J Child Neural. 2000;15(2):71-7.

 

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Information contained herein does not replace the recommendations of your healthcare professional. See the device manual for detailed information regarding the instructions for use, the implant procedure, indications, contraindications, warnings, precautions, and potential adverse events. For further information, contact your local Medtronic representative and/or consult the Medtronic website at www.medtronic.com