Intrathecal baclofen for progressive neurological disease in childhood: A systematic review of literature

BackgroundIntrathecal baclofen (ITB) treatment is frequently used for individuals with severe, but non-progressive, spasticity refractory to oral treatment. However, experiences with ITB in patients with progressive neurological disorders of childhood causing spasticity are limited.AimTo investigate whether ITB is an option in patients with progressive neurological disorders causing spasticity in childhood.DesignA systematic literature search in Embase, Pubmed and the Cochrane Library was performed.ResultsWe identified six eligible studies considering patients with progressive neurological disease in childhood and receiving ITB treatment. The studies included a total of seven paediatric patients and four adult patients. Improvement was reported in spasticity, spasms, pain, gait, activities of daily life and providing care. High satisfaction is described.ConclusionsITB has beneficial effects in paediatric patients with progressive neurological disease. However, the level of evidence is limited due to the small number of available studies and due to the poor quality of these studies.

► ITB improves daily care also in progressive neurological disease in childhood. ► A limited life expectance is no contra-indication for ITB. ► ITB improves spasticity and spasms progressive neurological disease in childhood. ► ITB Pump or catheter related complications are frequent.