Ann Rehabil Med.  2019 Jun;43(3):335-340. 10.5535/arm.2019.43.3.335.

Outcomes of Intrathecal Baclofen Therapy Compared With Deep Brain Stimulation in a Patient With Dystonic Cerebral Palsy: A Case Report

• Chae M
• Hong S
• Jung NY
• Chang WS
• Cho SR

• KMID: 2453924
• DOI: http://doi.org/10.5535/arm.2019.43.3.335

Abstract

Deep brain stimulation (DBS) in internal globus pallidus is considered to be a good option for controlling generalized dystonia in patients with this condition. In this relation, it is known that DBS has already been shown to have significant effects on primary dystonia, but is seen as controversial in secondary dystonia including cerebral palsy (CP). On the other hand, intrathecal baclofen (ITB) has been known to reduce spasticity and dystonia in patients who did not respond to oral medications or botulinum toxin treatment. Here, we report a patient with dystonic CP, who received the ITB pump implantation long after the DBS and who noted remarkable improvement in the 36-Item Short Form Health Survey, Dystonia Rating Scale, Modified Barthel Index, and visual analog scale scores for pain after an ITB pump implantation was used as compared with DBS. To our knowledge, the present case report is the first to demonstrate the effects of an ITB pump on reducing pain and dystonia and improving quality of life and satisfaction, compared with DBS in a patient with CP.

Keyword

Dystonia; Intrathecal baclofen pump; Deep brain stimulation; Cerebral palsy

MeSH Terms

Baclofen*
Botulinum Toxins
Cerebral Palsy*
Deep Brain Stimulation*
Dystonia
Dystonic Disorders
Globus Pallidus
Hand
Health Surveys
Humans
Muscle Spasticity
Quality of Life
Visual Analog Scale
Baclofen
Botulinum Toxins

Figure

• 

  Fig. 1. Plain skull X-ray (A) and brain computed tomography scan (B) showing a deep brain stimulation electrode located on the internal globus pallidus bilaterally.

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