{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:03:26Z","timestamp":1784257406840,"version":"3.55.0"},"reference-count":32,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2022,1,22]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>Increasing numbers of patients have an intrathecal baclofen pump implanted as part of spasticity management. Neurologists may be asked about the management of these devices when patients attend emergency departments for unrelated illnesses. Occasionally, the intrathecal baclofen system itself will directly lead to an acute presentation. Furthermore, the presence of an intrathecal baclofen pump needs consideration when requesting investigations, particularly MR imaging. This review aims to increase understanding of intrathecal baclofen treatment, highlighting serious complications and outlining considerations for routine investigations. Neurologists may still need advice from the intrathecal baclofen specialist team.<\/jats:p>","DOI":"10.1136\/practneurol-2021-003184","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T13:30:42Z","timestamp":1647869442000},"page":"241-246","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Intrathecal baclofen pumps: what the neurologist needs to know"],"prefix":"10.1136","volume":"22","author":[{"given":"Michelle S","family":"Balaratnam","sequence":"first","affiliation":[{"name":"Department of Neurosciences, King's College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie L","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Department of Therapies and Rehabilitation, National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"key":"2025090409473813000_22.3.241.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g4737"},{"key":"2025090409473813000_22.3.241.2","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.mpmed.2020.06.003","article-title":"Neurological rehabilitation and the management of spasticity","volume":"48","author":"Stevenson","year":"2020","journal-title":"Medicine"},{"key":"2025090409473813000_22.3.241.3","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2011-000155"},{"key":"2025090409473813000_22.3.241.4","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4522(78)90016-7"},{"key":"2025090409473813000_22.3.241.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1476-5381.1981.tb09137.x"},{"key":"2025090409473813000_22.3.241.6","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.msard.2018.10.009","article-title":"Intrathecal baclofen for multiple sclerosis related spasticity: a twenty year experience","volume":"27","author":"Sammaraiee","year":"2019","journal-title":"Mult Scler Relat Disord"},{"key":"2025090409473813000_22.3.241.7","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.clineuro.2011.10.046","article-title":"Intrathecal baclofen therapy for severe spasticity: analysis on a series of 112 consecutive patients and future prospectives","volume":"114","author":"Natale","year":"2012","journal-title":"Clin Neurol Neurosurg"},{"key":"2025090409473813000_22.3.241.8","doi-asserted-by":"publisher","DOI":"10.1177\/0269215513488607"},{"key":"2025090409473813000_22.3.241.9","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.pmrj.2013.12.005","article-title":"Long-term intrathecal baclofen: outcomes after more than 10 years of treatment","volume":"6","author":"Mathur","year":"2014","journal-title":"Pm R"},{"key":"2025090409473813000_22.3.241.10","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2006.104.2.233"},{"key":"2025090409473813000_22.3.241.11","first-page":"9","article-title":"Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients","volume":"104","author":"Vender","year":"2006","journal-title":"J Neurosurg"},{"key":"2025090409473813000_22.3.241.12","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e318287f02a"},{"key":"2025090409473813000_22.3.241.13","doi-asserted-by":"publisher","DOI":"10.1159\/000358307"},{"key":"2025090409473813000_22.3.241.14","doi-asserted-by":"publisher","DOI":"10.3171\/2013.11.PEDS13253"},{"key":"2025090409473813000_22.3.241.15","doi-asserted-by":"publisher","DOI":"10.1159\/000343202"},{"key":"2025090409473813000_22.3.241.16","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.3171\/2016.4.JNS152934","article-title":"Changing of the guard: reducing infection when replacing neural pacemakers","volume":"126","author":"Pepper","year":"2017","journal-title":"J Neurosurg"},{"key":"2025090409473813000_22.3.241.17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.16.1907"},{"key":"2025090409473813000_22.3.241.18","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1111\/ner.13071","article-title":"Reducing intrathecal baclofen related infections: service evaluation and best practice guidelines","volume":"23","author":"Balaratnam","year":"2020","journal-title":"Neuromodulation"},{"key":"2025090409473813000_22.3.241.19","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200011000-00010"},{"key":"2025090409473813000_22.3.241.20","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1016\/j.apmr.2013.12.019","article-title":"Occurrence of adverse events in long-term intrathecal baclofen infusion: a 1-year follow-up study of 158 adults","volume":"95","author":"Borrini","year":"2014","journal-title":"Arch Phys Med Rehabil"},{"key":"2025090409473813000_22.3.241.21","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)90228-4"},{"key":"2025090409473813000_22.3.241.22","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03460110084029"},{"key":"2025090409473813000_22.3.241.23","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1997.87.3.0415"},{"key":"2025090409473813000_22.3.241.24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198906083202303"},{"key":"2025090409473813000_22.3.241.25","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.clineuro.2014.05.024","article-title":"Intrathecal baclofen therapy for the symptomatic treatment of hereditary spastic paraplegia","volume":"123","author":"Margetis","year":"2014","journal-title":"Clin Neurol Neurosurg"},{"key":"2025090409473813000_22.3.241.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1403.2010.00308.x"},{"key":"2025090409473813000_22.3.241.27","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2017-317021"},{"key":"2025090409473813000_22.3.241.28","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2021.102831","article-title":"Evaluation of the cognitive benefits of intrathecal baclofen pump implantation in people with intractable multiple sclerosis related spasticity","volume":"50","author":"Farrell","year":"2021","journal-title":"Mult Scler Relat Disord"},{"key":"2025090409473813000_22.3.241.29","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1177\/1352458520936912","article-title":"Long-term outcomes of intrathecal baclofen in ambulatory multiple sclerosis patients: a single-center experience","volume":"27","author":"Abbatemarco","year":"2021","journal-title":"Mult Scler"},{"key":"2025090409473813000_22.3.241.30","first-page":"174","article-title":"Intrathecal baclofen pump replacements under local anaesthetic: rapid pathway implementation under COVID-19","volume":"16","author":"Keenan","year":"2020","journal-title":"BJJN"},{"key":"2025090409473813000_22.3.241.31","doi-asserted-by":"crossref","first-page":"273","DOI":"10.3171\/jns.1989.71.2.0273","article-title":"Physostigmine in the treatment of intrathecal baclofen overdose. Report of three cases","volume":"71","author":"M\u00fcller-Schwefe","year":"1989","journal-title":"J Neurosurg"},{"key":"2025090409473813000_22.3.241.32","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2011.112"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/practneurol-2021-003184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T16:47:54Z","timestamp":1757004474000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/practneurol-2021-003184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,21]]},"references-count":32,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,5,17]]},"published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1136\/practneurol-2021-003184"],"URL":"https:\/\/doi.org\/10.1136\/practneurol-2021-003184","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,21]]}}}