Intrathecal Baclofen in Patients With Persistent Vegetative State: 2 Hypotheses

摘要: Sara M, Pistoia F, Mura E, Onorati P, Govoni S. Intrathecal baclofen in patients with persistent vegetative state: 2 hypotheses. Arch Phys Med Rehabil 2009;90:1245-9. Sporadic cases of recovery from state (PVS) after administration intrathecal (ITB) have been reported without giving any possible explanation for its paradoxical effect. We summarize our recent findings on 5 PVS treated ITB and make some specula- tions the mechanisms responsible observed clinical improvement. The developed spasticity were judged eligible therapy. Two weeks pump im- plantation, began to show a improvement that, at end 6 months' follow-up, was stable all but 1 patient, ranging mere increased alertness full consciousness, as revealed by changes Coma Recovery Scale-Revised (CRS-R) score. Our suggest that might favor variable degree A proposal pharmacodynamic this effect has not formally put forward. hypothesize mechanisms: first, modulation confined spinal cord seg- mental activities neuronal centripetal outputs reaching cortex; second, sleep-wake cycles although present, may be dysregulated interfere alert- ness awareness. Although research is few subjects, it provides follow-up information means CRS-R validated standardized neurobehavioral instru- ment expressly designed use PVS. observations indicate further systematic investigation putative applications should undertaken.