Intrathecal Baclofen Therapy for Painful Muscle Spasms in a Patient with Friedreich ’s Ataxia

This report describes the successful management of painful spasms in a 65-year-old woman with FA via intrathecal baclofen (ITB) therapy followin g unsuccessful medical treatments. To our knowledge, this is the third reported case in the literature. Unfortunately, the pathophysiological characteristics of muscle spasms in FA are not well explored and understood while the therapeutic mechanisms of the different treatments are rather vague. Tak ing into consideration the suggested spinal atrophy in FA, the clinical resemblance of FA and chronic spinal injury muscle spasms, together with the rapid ITB therapy effectiveness in alleviating FA muscle spasms, we attempted to suggest a putative pathophysiological mechanism acting at the spinal l evel and possibly explained by the presence of independent spinal locomotor systems producing muscle spasms. Specifically, overexcitement of these centers, due to loss of normal regulation from upper CNS levels, may result in the uncontrolled firing of secondary motor neurons and may be the key to p roducing muscle spasms. However, further research under experimental and clinical settings seems to be necessary.Stereotact Funct Neurosurg

Source: Stereotactic and Functional Neurosurgery - June 8, 2018 Category: Neurosurgery Source Type: research