Neuromodulation : journal of the International Neuromodulation Society
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Intrathecal baclofen (ITB) therapy aims to reduce spasticity and provide functional control. ⋯ ITB dosing is multistep and individualized.
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Troubleshooting helps optimize intrathecal baclofen (ITB) therapy in cases of underdose, overdose, and infection. ⋯ Orderly troubleshooting helps ensure patient safety.
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Intrathecal baclofen (ITB) screening assesses response to a test dose of ITB on spasticity and function and identifies adverse reactions. ⋯ Screening helps identify appropriate candidates for ITB.
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When spasticity interferes with comfort, function, activities of daily living, mobility, positioning, or caregiver assistance, patients should be considered for intrathecal baclofen (ITB) therapy. ⋯ ITB should be considered when spasticity interferes with comfort or function.
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Neuraxial drug delivery via intrathecal drug delivery systems (IDDS) is becoming an increasingly common mode of treating intractable cancer-related pain, chronic pain, or severe spasticity. An implanted infusion pump delivers medication into the intrathecal (subarachnoid) space via a thin catheter. These pumps are commonly placed in the anterior abdominal wall. Certain conditions may render it difficult or unsafe for an IDDS to be implanted at the traditional site; thus, alternative sites have been explored. We report on the use of the upper antero-medial thigh as a safe alternative site for this purpose. ⋯ The upper antero-medial thigh is a safe alternative to the anterior abdominal wall for implantation of an IDDS.