Weight Gain in Children With Hypertonia of Cerebral Origin Receiving Intrathecal Baclofen Therapy

McCoy AA, Fox MA, Schaubel DE, Ayyangar RN. Weight gain in children with hypertonia of cerebral origin receiving intrathecal baclofen therapy.ObjectiveTo identify the pattern of weight change in children receiving intrathecal baclofen (ITB) therapy.DesignA retrospective medical chart review was conducted to identify weight status before and after ITB pump implantation.SettingTertiary care children’s hospital and academic medical center.ParticipantsAll children and adolescents with hypertonia of cerebral origin who were younger than 19 years of age at the time of pump placement and followed in our pediatric baclofen pump program.InterventionsNot applicable.Main Outcome MeasuresA linear mixed model was used to examine the rate of change in weight (weight-gain velocity) before and after surgery. Weight change was adjusted for age, sex, functional level determined by the Gross Motor Functional Classification System, tube feeding, dystonia, and other comorbidities.ResultsThe average weight-gain velocity was 2.32kg/y presurgery and 2.93kg/y postsurgery, adjusted for potential confounders. The 0.61kg/y increase in weight-gain velocity attained statistical significance (P=.028).ConclusionsAlthough excessive weight gain is not a common problem in children with cerebral origin spasticity, increased weight-gain velocity is prevalent in children receiving ITB therapy. Health care providers may anticipate a welcome weight gain in the underweight child. This consequence should be considered when managing children receiving ITB therapy, and health care providers must appropriately intervene to prevent excessive weight gain. Further studies exploring the reasons for the increased weight-gain velocity are warranted.