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Intrathecal Baclofen Pump for Severe Spasticity and Dystonia (5333)

Intrathecal Baclofen Pump for Severe Spasticity and Dystonia (5333) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Neuro, Rehab

5333


Intrathecal Baclofen Pump
for Severe Spasticity and Dystonia

What is Spasticity and Dystonia?
 Spasticity is increased resistance to
muscle movement. The faster the
muscle is moved, the greater the
stiffness.
 Dystonia is unintentional muscle
tightening.
 Together spasticity and dystonia
result in twisting and odd postures.
 In children, this is often described as
going between being limp as a
noodle and tight as a board.
 People with spinal cord injury may
have severe spasticity.
 Spasticity and dystonia may be seen
in people with cerebral palsy. It can
also be seen in those with a brain
injury.
 Spasticity and dystonia often causes
problems with ease of movement,
comfort, and care giving.

What is Intrathecal Baclofen?
ξ Baclofen is a medicine that eases
muscle movement.
ξ Baclofen can be given by mouth.
ξ If the oral form isn’t helping enough,
it can be given into the cerebral
spinal fluid (CSF). “Intrathecal”
refers to giving medicine directly
into the CSF.
ξ If the spinal fluid route is used, a
pump is needed. The pump is
implanted inside the body. The
pump allows the baclofen to be
infused around the clock.


Who would be helped with a Baclofen
Pump?
A baclofen pump may help if:
 Spasticity or dystonia which affects
the arms and legs.
 Problems with daily care, pain, or
sleep.
 The body is big enough to hold the
pump.
 Enough strength in the neck and
trunk.

How is my child assessed for the pump?
Each child is assessed by a team of doctors,
nurses, and therapists. This takes place in the
Spasticity and Movements Disorders clinic
at AFCH. Parents can ask their child’s
primary doctor for a referral to the center.
Parents may call 608-263-6420, option 3 to
schedule an appointment.


How is the intrathecal baclofen pump
placed?
The system includes a pump, a tube
(catheter) that goes into the spinal column,
and a computer. The disc shaped pump is
about 3 inches wide and 1 inch thick. It uses
a lithium battery that last 7 years.









ξ Through a small incision in the back,
the baclofen pump tube is threaded
into the spinal column. The other end
of the tube is guided to the
abdominal region and attached to the
pump.
ξ The pump is placed through an
incision in the mid to lower
abdomen.
ξ The pump is set to give a fixed
amount of baclofen over 24 hours.
ξ Surgery takes about 2 hours.

What happens before surgery?
 You will need a physical exam,
health review, and lab tests.
 Please stop aspirin and ibuprofen for
two weeks before surgery. It is
alright to use acetaminophen
(Tylenol®) if needed.
 You will wash with Sage clothes as
instructed.
 You will receive a phone call the day
before surgery telling you when to
stop eating and drinking.
 Do not wear make-up, jewelry, or
nail polish to surgery.

What happens after surgery?
ξ There is mild pain involved with
this. Pain relievers can be used to
increase comfort.
ξ When you are eating and drinking
normally, you will go home.
ξ Plan for a 3 to 5 day hospital stay.
ξ You will have a bandage covering
the incisions. You will need to keep
this dry and clean.
ξ You will have a clinic visit in 7-10
days. Your bandage and staples will
be removed at this time.
ξ You should wait at least two weeks
after surgery before getting any
immunizations.
ξ The pump is filled with baclofen at
the time of surgery. The pump will
be adjusted as needed while in the
hospital.
ξ Check the incisions twice a day until
they are healed.
ξ Call right away if you notice:
o Redness, pain, or swelling of the
skin at or near the site.
o Drainage from the incision.
o Fever greater than 101.5ºF in the
first three months after surgery.
o Headaches that keep coming
back.

Are there any activities that should be
avoided?
While the pump is in place your child should
avoid:
 Extreme temperature and pressure
changes.
 Saunas or hot tubs with temperatures
over 102 θ F.
 Scuba diving under 2 atmospheres.
 Unpressurized aircraft.
 Bungee jumping.
 Sky diving.


When should I call?
For signs of baclofen withdrawal or
overdose.

What is baclofen withdrawal?
ξ You should always have an up-to-
date and filled prescription of oral
baclofen on hand.
ξ If the pump does not work or the
small tube becomes clogged or
disconnected, your child may have
symptoms of baclofen withdrawal.
Give the oral baclofen.
ξ Call your child’s health care provider
and make arrangements to be seen
the same day.

Symptoms of baclofen withdrawal are:
 Severely increased spasticity or
dystonia.
 Severe sweating.
 Severe itching without a rash.
 Fever.
 Seizures.
 Fast heart rate.
 Rapid breathing.
 Agitation.
 Irritability.
What is baclofen overdose?
If your child has too much baclofen, you
may see the symptoms listed below. Call
right away if you see these symptoms.
 Listless.
 Floppy.
 Very sleepy.
 Lightheaded or dizzy.
 Breathes slowly.

Will my child need routine follow – up?
Patients with baclofen pumps will need
regular clinic follow up for dose changes
and for pump refills. It is vital to keep these
appointments.

Phone Numbers
American Family Children’s Hospital
Clinics: (608) 263-6420, option 3

After hours, weekends and holidays, call the
paging operator at (608) 262-0486. Ask for
the neurosurgeon on call. Leave your name
and phone number with the area code. The
doctor will call you back. If you live out of
the area, call 1-800-323-8942.












Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 3/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5333