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Spasticity of Spinal Cord OriginEvidence supporting the efficacy of LIORESAL INTRATHECAL was obtained in randomizedcontrolled investigations that compared the effects of either a single intrathecal dose or a three day intrathecal infusion of LIORESAL INTRATHECAL to placebo in patients with severe spasticity and spasms due to either spinal cord trauma or multiple sclerosisLIORESAL INTRATHECAL was superior to placebo on both principal outcome measures employedchange from baseline in the Ashworth rating of spasticity and the frequency of spasms.

Intrathecal massCases of intrathecal mass at the tip of the implanted catheter have been reportedmost of them involving pharmacy compounded analgesic admixturesThe most frequent symptoms associated with intrathecal mass are1decreased therapeutic responseworsening spasticityreturn of spasticity when previously well controlledwithdrawal symptomspoor response to escalating dosesor frequent or large dosage increases2pain3neurological deficit/dysfunctionClinicians should monitor patients on intraspinal therapy carefully for any new neurological signs or symptomsIn patients with new neurological signs or symptoms suggestive of an intrathecal massconsider a neurosurgical consultationsince many of the symptoms of inflammatory mass are not unlike the symptoms experienced by patients with severe spasticity from their diseaseIn some casesperformance of an imaging procedure may be appropriate to confirm or rule-out the diagnosis of an intrathecal mass.

Intrathecal massCases of intrathecal mass at the tip of the implanted catheter have been reportedmost of them involving pharmacy compounded analgesic admixturesThe most frequent symptoms associated with intrathecal mass are1decreased therapeutic responseworsening spasticityreturn of spasticity when previously well controlledwithdrawal symptomspoor response to escalating dosesor frequent or large dosage increases2pain3neurological deficit/dysfunctionClinicians should monitor patients on intraspinal therapy carefully for any new neurological signs or symptomsIn patients with new neurological signs or symptoms suggestive of an intrathecal massconsider a neurosurgical consultationsince many of the symptoms of inflammatory mass are not unlike the symptoms experienced by patients with severe spasticity from their diseaseIn some casesperformance of an imaging procedure may be appropriate to confirm or rule-out the diagnosis of an intrathecal mass.

Abrupt discontinuation of intrathecal baclofenregardless of the causehas resulted in sequelae that include high feveraltered mental statusexaggerated rebound spasticityand muscle rigiditythat in rare cases has advanced to rhabdomyolysismultiple organ-system failure and death.

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