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Seventeen patients with congenital spastic cerebral palsy and six patients with other forms of spasticity were injected intrathecally with doses of placebo or baclofen,25 ug,50 ug,or 100 ug,in a randomized,double-blind manner.Muscle tone in the upper and lower extremities was assessed by Ashworth scores both before the injections and every 2 hours afterward for 8 hours.Function of the upper extremities was evaluated before the injections and 4 hours afterward.Muscle tone in the lower extremities was significantly decreased within 2 hours after baclofen injection and remained lower than baseline 8 hours afterward.Upper extremity tone and function were not significantly affected by these single doses.Confusion and drowsiness occurred in two of the youngest children in the study after the 50-ug dose,but cleared within 2 hours.Our findings indicate that intrathecal baclofen reduces spasticity in children with cerebral palsy,as it does in adults with spasticity of spinal origin. |
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