Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD

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  1. 2023;7;201-203 Intrathecal Baclofen to Improve Functional Status in ALS: A Case Report
    Case Report
    Mark P. Pressler, MD, Peter S. Cooper, MD, Whitney Carter, BS, Robert B. Goldstein, MD, and Andrew M. Mendelson, DO.

Background: Intrathecal pumps are well known to benefit patients with chronic pain as well as spasticity. Intrathecal baclofen (ITB) can offer doses 100-1000 times smaller with similar efficacy, compared to oral baclofen. Only 2 previous reports detailed improvement in functional status after patients with amyotrophic lateral sclerosis (ALS) received ITB.

Case Report: Our patient presented with progressive bulbar palsy, further progressing to ALS. His lower extremity spasticity and tremors continued to progress over 3 years despite increased baclofen. At the time of implant, he expressed whole body tremors and spasticity to bilateral lower extremities, complicated by falls. Prior to the trial, the patient ambulated 50 feet. ITB was started at a rate of 100 mcg/day. After the implant, the patient’s ambulation distance increased to 100 feet.

Conclusion: The patient and his wife reported resolution of his tremors and improvement in spasticity. This report details the functional improvement obtained from ITB in a patient with ALS.

Key words: Amyotrophic lateral sclerosis (ALS), intrathecal, baclofen, functional status, chronic pain, interventional pain