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Rehabilitation Practice and Science

Translated Title

新抗痙攣藥Baclofen之臨床試用經驗

Abstract

Baclofen,a derivative of gamma-aminobutyric acid, was introduced in 1966 as a possible treatment for spasticity due to cortico-spinal tract lesions. The previous reports suggested that it may be more effective than other spasmolytic agents, currently available. This report presents our experience with baclofen in the management of spasticity in 45 hospitalized patients of department of rehabilitation in NTUH. Among them, 25 cases were cerebral lesion (3 head injured, 22 cerebral vascular diceased),20 cases were spinal cord lesion (11 quadriplegic,9 paraplegic). 36 cases were males and 9 cases were females. The age distribution was from 13 years old to 74 years old, with the mean age of 46 years.The duration of treatment ranged from 5 days to 130 days, wth the avarage of 44 days. Among them, 27cases(60%)were treated over 4 weeks The most common dose was 60mg per day. The total effective rate was 80% in which 58% was markedly effective and 22% was slightly effective. The markedly effectively rate in cerebral lesion group was 52% while that in spinal cord lesion group was 65%。The overall effective rate in either group was 80%. The evident side effects were seen in 7 cases, in elude dizzinese (3cases), general weakness (2cases), sleepiness (2cases) and hypotension(lcase) The occurring rate was 16%.。 There was no definite abnormalities in urinalysis, hemogram and blood chemistry examinations directly related to the use of baclofen in this study. The precise mechanism of effects of baclofen is still not well known, currently it is thought that activation of GABAB receptors by baclofen restricts calcium in-flux into pre-synaptic terminals and that it is this restriction that reduces evoked transmitter release In turn, the reduction of excitatory transmitter release by afferent fibers is responsible for the diminished reflex acxity. While the precise mechanism is still not sure, baclofen appears to be a safe and effective drug in the management of spasticity, especially strong spasticity and spasticity related to spinal cord lesion, as compared with diazepam. For it is better tolerated even at large dose, without side effects of general weakness and sleepiness.

Language

Traditional Chinese

First Page

38

Last Page

44

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