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Suggest Treatment For Severe Pain In A Person With Spasticity And Cerebral Palsy

Posted on Tue, 22 Sep 2015

Question: daughter 38 years old, spasticity, cerebbral palsy, XXXXXXX until 5 years ago. now cerebral atrophy, maybe. only two cts done could have always been this way, she is deterioating, now on 4 different muscle relaxers and botox injections, she is either sedated or screaming, pain? i do not know what to do, she continues to decline and is so curved her wheelchair is not comfortable

Answered by Dr. Dr. Erion Spaho (1 hour later)

Brief Answer:
Baclofen pump.

Detailed Answer:
Hello and thanks for using HCM.

Sorry to hear about all these troubles.

I have read your question and understand your concerns.

Severe spasticity, when drugs taken by mouth, or injection fail to improve, is treated by intrathecal Baclofen injection, or Baclofen pump.

This invasive method deliverers continuously Baclofen into spinal cord, improving this way spasticity.

You should discuss with your doughter's Doctor about this possible way to help somewhat your doughter.

Hope this helps.

Best regards.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Dr. Erion Spaho (1 hour later)

They tell me, the neurologist, that the pump is primarily for lower torso.. She has problems there LAO BUT HER ARMS ARE SO TIGHT THAT UNTIL WE TRIED BOTOX INJECTIONS SHE HAD BRUISES UNDER CHIn AND ALL ACROSS HER BREASTS. SORRY FOR CAPS, i DO NOT TYPE WELL. dOCTOR SAYS CALL HOSPICE, THEY SAY ALL HER VITAL SIGNS ARE GREAT EXCEPT SHE BREATHES VERY SHALLOW. wHAT ABOUT A PAIN CLINIC AND INJECTIONS OF SOME KIND, i AM AFRAID OF MORE MEDS.

Answered by Dr. Dr. Erion Spaho (8 hours later)

Brief Answer:
Again Baclofen pump.

Detailed Answer:
Welcome back.

Baclofen pump is implemented at abdomen and delivers Baclofen into cerebrospinal fluid.

The implantion of catheter is into lumbar spine, but Baclofen is delivered and spreads through cerebrospinal fluid into all spinal cord relieving spasticity in both arms and.

Get a Neurosurgeon opinion about it.

In my opinion, this is the best solution at the moment.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Erion Spaho (5 hours later)

Thank you for your patience. We did see a neurosurgeon with a referral from our neurologist, but that was due to his concern with possible hydrocephaus. The mri showed increased fluid due to increased shrinkage of her brain. I guess at this point I have to ask if she would survive surgery or leave her in pain. I am not sure I can get a doctor to do it. She has medicare... I will ask her doctor for a referral for this surgery armed with the knowledge you have given me. Thanks again, with greetings from living hell, XXXXXXX

Answered by Dr. Dr. Erion Spaho (29 minutes later)

Brief Answer:
It is a minimally invasive and short time surgery.

Detailed Answer:
Hello again XXXXXXX

You reported that blood tests were okay, and if heart function is okay too, there are no contraindications about the implantion of Baclofen pump.

It is a minimally invasive and short time surgery, so, I don't see any serious reason not to do it.

You know better than me, leaving her in pain is the worst thing to do.

Hope I helped you.

Best regards.

Above answer was peer-reviewed by : Dr. Raju A.T