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Intrathecal baclofen therapy in stiff-man syndrome: a double-blind, placebo-controlled trial. 1995

P L Silbert, and J Y Matsumoto, and P G McManis, and K A Stolp-Smith, and B A Elliott, and K M McEvoy
Department of Neurology, Mayo Clinic, Rochester, MN 55904, USA.

We performed a double-blind, placebo-controlled trial of intrathecal baclofen (ITB) in stiff-man syndrome. Three patients, unresponsive to current therapy, received 50 micrograms of ITB or placebo on sequential days. Following ITB, all patients demonstrated improvement in reflex EMG activity. The mean reduction in total EMG activity (from all muscles) following stimulation of the medial plantar nerve (cutaneous flexor reflex) was 72% following 50 micrograms of ITB compared with 18% following placebo (ANOVA: significance of F, p < 0.0001). The mean latency to onset of the response was also significantly prolonged for all muscles following ITB (ANOVA: significance of F, p < 0.05). Although reflex EMG activity was reduced in all patients, clinical improvement was evident in only one patient, who differed from the others studied by a longer duration of disease, greater severity of stiffness, less fear of falling, and greater electrophysiologic improvement.

UI MeSH Term Description Entries
D007278 Injections, Spinal Introduction of therapeutic agents into the spinal region using a needle and syringe. Injections, Intraspinal,Injections, Intrathecal,Intraspinal Injections,Intrathecal Injections,Spinal Injections,Injection, Intraspinal,Injection, Intrathecal,Injection, Spinal,Intraspinal Injection,Intrathecal Injection,Spinal Injection
D011930 Reaction Time The time from the onset of a stimulus until a response is observed. Response Latency,Response Speed,Response Time,Latency, Response,Reaction Times,Response Latencies,Response Times,Speed, Response,Speeds, Response
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000704 Analysis of Variance A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. ANOVA,Analysis, Variance,Variance Analysis,Analyses, Variance,Variance Analyses
D001418 Baclofen A GAMMA-AMINOBUTYRIC ACID derivative that is a specific agonist of GABA-B RECEPTORS. It is used in the treatment of MUSCLE SPASTICITY, especially that due to SPINAL CORD INJURIES. Its therapeutic effects result from actions at spinal and supraspinal sites, generally the reduction of excitatory transmission. Baclophen,Chlorophenyl GABA,Apo-Baclofen,Atrofen,Ba-34,647,Ba-34647,Baclofen AWD,Baclofène-Irex,Baclospas,CIBA-34,647-BA,Clofen,Gen-Baclofen,Genpharm,Lebic,Lioresal,Liorésal,Nu-Baclo,PCP-GABA,PMS-Baclofen,beta-(Aminomethyl)-4-chlorobenzenepropanoic Acid,beta-(p-Chlorophenyl)-gamma-aminobutyric Acid,AWD, Baclofen,Apo Baclofen,ApoBaclofen,Ba34,647,Ba34647,Baclofène Irex,BaclofèneIrex,CIBA34,647BA,GABA, Chlorophenyl,Gen Baclofen,GenBaclofen,Nu Baclo,NuBaclo,PMS Baclofen,PMSBaclofen
D016750 Stiff-Person Syndrome A condition characterized by persistent spasms (SPASM) involving multiple muscles, primarily in the lower limbs and trunk. The illness tends to occur in the fourth to sixth decade of life, presenting with intermittent spasms that become continuous. Minor sensory stimuli, such as noise and light touch, precipitate severe spasms. Spasms do not occur during sleep and only rarely involve cranial muscles. Respiration may become impaired in advanced cases. (Adams et al., Principles of Neurology, 6th ed, p1492; Neurology 1998 Jul;51(1):85-93) Moersch-Woltmann Syndrome,Stiff-Man Syndrome,Congenital Stiff-Man Syndrome,Congenital Stiff-Person Syndrome,Familial Hyperekplexia,Hereditary Hyperekplexia,Startle Syndrome,Stiff-Baby Syndrome,Stiff-Trunk Syndrome,Stiffman Syndrome,Congenital Stiff Man Syndrome,Congenital Stiff-Man Syndromes,Congenital Stiff-Person Syndromes,Familial Hyperekplexias,Hereditary Hyperekplexias,Hyperekplexia, Familial,Hyperekplexia, Hereditary,Hyperekplexias, Familial,Hyperekplexias, Hereditary,Moersch Woltmann Syndrome,Startle Syndromes,Stiff Man Syndrome,Stiff Person Syndrome,Stiff Trunk Syndrome,Stiff-Baby Syndromes,Stiff-Man Syndrome, Congenital,Stiff-Man Syndromes, Congenital,Stiff-Person Syndrome, Congenital,Stiff-Person Syndromes, Congenital,Stiff-Trunk Syndromes,Syndrome, Congenital Stiff-Man,Syndrome, Congenital Stiff-Person,Syndrome, Moersch-Woltmann,Syndrome, Startle,Syndrome, Stiff-Baby,Syndrome, Stiff-Man,Syndrome, Stiff-Person,Syndrome, Stiff-Trunk,Syndrome, Stiffman,Syndromes, Congenital Stiff-Man,Syndromes, Congenital Stiff-Person,Syndromes, Startle,Syndromes, Stiff-Baby,Syndromes, Stiff-Trunk

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