Objective: To evaluate the effects of intrathecal baclofen therapy (ITB) in patients with severe spasticity. Material and Methods: Patients who had a baclofen pump implanted between 2004-2012 were included in the study. The inclusion criteria were severe spasticity with nonresponse to medical oral therapy and physiotherapy, modified Ashworth scale (MAS) score 3-4, and Penn's spasm scale (PSS) score 3-4. The ITB assessment criteria were MAS, PSS, visual analog scale (VAS), functional independence measurement (FIM), and short form-36 (SF-36) Tests were given before ITB and 3 months after implantation. Results: Twenty-one patients were given the test dose, and the ITB pump was implanted for 16. There were 11 men (68.75%) and 5 women (31.25%). Mean age was 33±10.34, ranging between 12-53 years. Eleven (68.75%) had spinal cord injury, 2 (12.50%) had multiple sclerosis, 2 (12.50%) had cerebral palsy, and 1 (6.25%) had a hypoxic brain. Eleven (68.75%) of these patients were paraplegic, 4 were (25%) tetraplegic, and 1 had (6.25%) dystonic cerebral palsy. Mean follow-up was 52.25±33.10 months, ranging between 3-100 months. Daily baclofen dose was between 70-475 µg (average 220±110.58 µg). Modified Ashworth scale decreased from 3.43±0.53 to 1.00±0.73 (p=0.00); PSS decreased from 3.50±1.03 to 1.12±1.02 (p=0.001); global pain decreased from 44.37±36.14 to 18.75±19.95, (p=0.003

Hysterical paralysis, a type of conversion disorder, presents with the loss of motor or sensory function. Although this disorder is nonorganic, it resembles the symptoms of a structural disease of the nervous system. It is generally associated with a traumatic or social event. The patients often require excessive testing and comprehensive assessment in exposing this psychogenic ailment. We reported the most dramatic type of conversion disorder, hysterical paralysis, in which full recovery was obtained with early recognition and rehabilitation approach including faradic stimulation.