Local-Spinal Therapy of Spasticity 1988
DOI: 10.1007/978-3-642-72954-6_17
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Pharmacokinetics of Intrathecal Baclofen

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Cited by 61 publications
(37 citation statements)
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“…Several studies have demonstrated the lumbar-to-cistern CSF baclofen concentration gradient is 4.1:1. 24, 25 Muller et al 11 found that continuous intrathecal infusion of 400 g/d may produce a spinal CSF level of 380 ng/mm. However, in studies concerning the use of orally administered baclofen, Knuttson et al 25 found that the highest measured spinal CSF level in 11 patients was 95 ng/mm.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Several studies have demonstrated the lumbar-to-cistern CSF baclofen concentration gradient is 4.1:1. 24, 25 Muller et al 11 found that continuous intrathecal infusion of 400 g/d may produce a spinal CSF level of 380 ng/mm. However, in studies concerning the use of orally administered baclofen, Knuttson et al 25 found that the highest measured spinal CSF level in 11 patients was 95 ng/mm.…”
Section: Discussionmentioning
confidence: 99%
“…[7][8][9] Baclofen, 4-amino-3 (p-chlorophenyl) butyric acid, is structurally similar to gamma aminobutyric acid (GABA) and binds to presynaptic GABA-B receptors within the brain stem, dorsal horn of the spinal cord, and other central nervous system (CNS) sites. [3][4][5]10,11,[15][16][17][18][19][20][21][22] The intrathecal infusion of baclofen through chronically placed catheters has been reported to be useful in treating spastic hypertonia in adults with spinal cord injury, multiple sclerosis, cerebral palsy and acquired brain injury. 7,8,10,[12][13][14] The delivery system consists of a subcutaneously placed pump with a reservoir attached to an intraspinal catheter.…”
mentioning
confidence: 99%
“…The markedly extended depression of the micturition reflex in rats that have been tracted with extremely high doses (10 gg) [6] and the decrease in sphincter activity in dogs exhibiting an intact spinal cord that have been given doses of 30 gg/kg [9] were probably caused by the influence of baclofen on supraspinal centers. The extremely low plasma levels obtained during intrathecal baclofen treatment [13] are insufficient for CNS modulations; therefore, the marked influence of such treatment on brain-stem centers can be explained only by massive cephalad migration of baclofen in the CSE At the normally used intrathecal doses, the rapid uptake of baclofen by the spinal cord prevents extensive rostral spread.…”
Section: Discussionmentioning
confidence: 97%
“…A more lipophilic analogue, baclofen [beta-(4-chlorophenyl)-GABA], was developed for oral administration. However, the passage of baclofen through the blood-brain barrier is limited [3,13]. The low therapeutic index of the substance limits dose increments and due to the resulting low levels in the CNS, severe somatic muscle spasticity as well as micturition disorders in neurogenic bladder disease are insufficiently controlled by oral administration of baclofen.…”
mentioning
confidence: 99%
“…For a single-bolus technique, drug is injected in the operating room and then the patient is watched in the recovery room until stable. A bolus typically provides maximal benefit to the lower extremities at ϳ60 min, affects the upper extremities at 2 h, and has maximal affects at 4 h, with the effects waning at 8 -10 h. 41,42 Using these time frames, the patient should be assessed by physical therapy, or a member of the surgical team with knowledge of the Ashworth scale, for clinical improvement. If the patient has responded to the test injection with diminished spasticity, he or she is returned the following day for definitive pump placement.…”
Section: Patient Selection For Intrathecal Baclofenmentioning
confidence: 99%