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Response of intrathecal baclofen resistance to dose reduction

From the Spasticity Management Program, Alta Bates Summit Medical Center, and East Bay Physicians Medical Group, Berkeley, CA.

Address correspondence and reprint requests to Dr Cooper, East Bay Physicians Medical Group, 3000 Colby St., Suite 101, Berkeley, CA 94705; e-mail: Cooperj2{at}sutterhealth.org.

Dose stabilization of intrathecal baclofen (ITB) is usually achieved within 6 to18 months. In some patients, an increase in ITB dose may result in paradoxical unresponsiveness to baclofen. We present two cases demonstrating increased tone and functional decline with increasing ITB doses after a period of clinical stability. In both cases, reduction of ITB dose was associated with marked clinical improvement.

Disclosure: The authors report no conflicts of interest.

Received August 1, 2005. Accepted in final form July 5, 2006.