Intrathecal Baclofen Pump Therapy for Multiple Sclerosis (MS)
Danette C. Taylor, DO, MS, FACN
Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
- What is multiple sclerosis (MS)?
- What is spasticity?
- What is baclofen, and what are its side effects?
- How is an intrathecal baclofen pump used to treat multiple sclerosis (MS)?
- Who is a good candidate for an intrathecal baclofen pump?
- How does an intrathecal baclofen pump work?
- How can I expect to feel after having an intrathecal baclofen pump implanted?
- What are the potential risks and side effects of an intrathecal baclofen pump?
- How much does a pump cost? Does insurance cover a intrathecal baclofen pump?
What is multiple sclerosis (MS)?
Multiple sclerosis (MS) is a disease that causes demyelination of the brain and spinal cord, or a loss of the protective covering around nerve fibers called axons. When this occurs, the axons (the parts of the nerve cells that transmit impulses to other cells) don't work well. As more areas are affected by the loss of myelin, different symptoms develop. The specific symptoms seen in MS are related to the area of injury in the brain or spinal cord. Patients might experience or describe numbness, tingling, or weakness. The weakness might be mild or severe enough to cause paralysis of one side of the body. In some cases, patients may develop loss of control of their bladder or an inability to empty their bladder. As MS progresses, some patients are left with muscle spasticity, which is an involuntary painful contraction of some muscles.
What is spasticity?
Spasticity is a condition in which muscles are exhibiting almost constant contracture or activity, leading to loss of range of motion, decreased function, and even pain. Spasticity occurs after an area of the brain or spinal cord has been injured, leading to weakness and increased tone. When an arm or leg that is affected by spasticity is moved by a health-care professional, there is involuntary resistance to that movement. Often, this spasticity is made worse when the speed (or velocity) of the movement increases. Spasticity is often seen in association with a brain injury, such as after:
- a stroke,
- traumatic damage to the brain or spinal cord, or
- in cases of MS.
What is baclofen, and what are its side effects?
Baclofen is a medication that works in the brain to decrease uninhibited signals that start in an injured area of the brain and cause spasticity. By decreasing these signals, the affected muscle can relax somewhat, and the symptoms of spasticity can be reduced. When taken in pill form baclofen can be effective, but can lead to side effects such as:
These side effects can limit the amount of medication that can be used to decrease the symptoms of spasticity. However, the medication can also be injected around the spinal cord, directly into the cerebral spinal fluid. When used in this way, only small amounts of the medication are needed, and side effects may be reduced.
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