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Neurologists Offer Stroke Patients
New Treatment for Spasticity
Surgically implanted pump releases drug to loosen muscles, alleviate crippling pain
Stanley Fisher, M.D., left, chief resident in neurology at the UT Medical School at Houston, checks patient David Jones, who had a stroke three years ago at the age of 32. Jones had a pump surgically implanted to dispense an anti-spasmodic drug.
Photos by Shannon Rasp
Neurologists at The University of Texas Medical School at Houston are testing a surgically inserted pump that dispenses an anti-spasmodic drug directly into the spinal cord area. The device, called the “intrathecal baclofen” pump, is used with stroke patients suffering from rigid, spastic muscles.
Patients are treated with the drug before the pump is inserted to determine if they respond to it. If they do, the pump is then surgically implanted in the waist area of people who have had strokes and are experiencing spasticity in their muscles as a result.
“The pump releases an anti-spasmodic drug, baclofen, directly into the spinal cord area,” said Stan Fisher, M.D., an investigator in the study and chief neurology resident at the Medical School. “Baclofen enables their muscles to loosen, allowing patients to participate in physical therapy and alleviating the literally crippling pain of the spasms.”
The pump itself is made out of titanium and is about three inches in circumference. A computer makes adjustments in the medication dosage being released into the body – so, no surgery is necessary for adjustments. About every three months, the patients must have the pump refilled with baclofen, a simple procedure that is done in the doctor’s office.
A baclofen pump is held next to the incision where patient David Jones had his pump inserted. Jones has reported improved mobility and less rigidity in his muscles since the pump was implanted. He anticipates returning soon to his pre-stroke hobbies of scuba diving and horseback riding.
Baclofen, approved by the Food and Drug Administration in 1996, has been used as an oral medication in stroke patients, as well as those suffering from multiple sclerosis and cerebral palsy. However, Fisher said, if it is to be effective while taken orally, it needs to be taken in extremely high doses, and it often affects the brain and healthy muscles as well as those in spasm.
“The pump is a much more accurate and, for the patient, tolerable way of administering the drug,” Fisher said.
Candidates for the trial must have had a stroke at least six months ago and be experiencing spasticity in their arms and legs. Patients seeking to participate in the study should ask their doctors for a referral to the specialty neurology clinic of the UT Health Science Center at Houston, 6410 Fannin St.
Trial participation is not free, but all major insurance plans are accepted by the clinic and cover the pump insertion and the necessary doctor consultations. For more information, call (713) 500-7123.
— By Shannon Rasp, Public Affairs