Efectividad de baclofeno en el tratamiento de espasticidad de origen cerebral

Abstract

Objectives: to evaluate the effectiveness of baclofen versus placebo to reduce spasticity and improve motor function, functional autonomy, and self care. Design: prospective two stages, 6-week each, baclofen (1 to 2 mg · kg · day) and placebo (thiamine, 37.5 mg · d) cross over administration trial. Subjects: patients with spastic cerebral palsy living in a charity institution for invalid youngsters under medical care of a university associated public general hospital pediatric neurology clinic at metropolitan Santiago, Chile. Twenty persons aged 3 to 26 years with spastic cerebral palsy. Measurements and results: weekly assessments of skeletal muscle tone with the Ashworth scale (scored 1 to 5 from normal through severe rigidity) showed significant reduction of spasticity, from scores 3 or more in all patients at basal and 19/20 at placebo evaluations to ten patients achieving score 2 under baclofen treatment (Wilcoxon test p < 0.05). Improvement in spontaneous movement and in routine care management participation was observed in nine patients. No changes in motor function were recorded. Greater improvement was seen in patients with better intelligence levels and less severe motor dysfunction. Conclusion: baclofen should be considered a useful additional aid in the management of patients with spastic cerebral palsy. Further studies should be done to assess long term effects of baclofen on these patients.