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Electrophysiological assessment of the effect of intrathecal baclofen in spastic children

par Dachy, Bernard ;Dan, Bernard
Référence Clinical neurophysiology, 113, 3, page (336-340)
Publication Publié, 2002

Article révisé par les pairs

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Résumé :

Objectives: To evaluate the effect of intrathecal baclofen in a group of spastic children using electrophysiological procedures described in adults. Methods: Six children (aged 1-14 years) with severe spasticity of various aetiologies underwent transcranial magnetic stimulation, H reflex and flexor reflex studies before and after intrathecal injection of baclofen. Ashworth scale was used for clinical evaluation of spasticity. Results: Motor evoked potentials, present in two patients before baclofen, were preserved after injection. Before baclofen, H reflex was present in 5 patients (Hmax/Mmax from 0.23 to 0.84) and absent in one who had infantile neuroaxonal dystrophy. After baclofen, it was absent in 4 patients and markedly reduced in one. Surface of flexor reflex significantly decreased after baclofen (P = 0.01), while threshold significantly increased (P = 0.003). Conclusions: In spastic children, the action of baclofen on spinal pathways may be quantified by the same electrophysiological procedures as in adults. This approach may contribute to select optimal dosage. © 2002 Elsevier Science Ireland Ltd. All rights reserved.