Implanted pump systems for treatment of XXXX .

@entity1 @entity1545 @entity131 @entity508 @entity519 @entity1566 @entity1772 @entity15 @entity130 @entity306
In about one third of @entity1 with @entity508 due to spinal @entity130 , @entity15 , and @entity1545 adequate control with oral antispastic medication cannot be achieved and successful rehabilitation is severely handicapped. In the past these @entity1 were subjected to destructive chemical procedures or extensive surgery. The authors present the results of management of uncontrollable @entity508 by means of continuous intrathecal administration of @entity1772 with a totally implantable gas driven pump system (Infusaid). 30 @entity1 were treated between June 1985 and January. 1987. The main indication was incapacitating @entity508 resistant to oral treatment with @entity1772 and caused by @entity1566 or lesion (11 @entity1 ), @entity15 (11 @entity1 ), @entity306 (3 @entity1 ) and @entity131 , @entity519 or ischaemia (5 @entity1 ). Clinical assessment included @entity508 scores, integrated electromyography (Iemg) and motography. Effective control for @entity508 with mean reduction of Iemg by 55%, decrease of Ashworth's score from 3 to 0 and improvement of life quality was obtained in all @entity1 with daily dose of 10-800 micrograms of @entity1772 . Voluntary resting motoricity was not impaired and there were no untoward central side effects. The excellent effect of intrathecal @entity1772 in comparison with oral therapy is explained by local, spinal GABAergic inhibitory action of the drug which is delivered directly into spinal subarachnoid space. Dose finding and dose adjustment is performed prior to pump implantation by intermittent injections into a subcutaneous port. The complications of the procedure were minor (catheter displacement, disconnection) and easily correctable.(ABSTRACT TRUNCATED AT 250 WORDS)
