Intrathecal baclofen for spasticity in cerebral palsy

Article Abstract:

Spasticity, or abnormally increased muscle tone, causes voluntary muscle movements to be stiff and awkward, and afflicts most children with cerebral palsy (CP). Most drugs that have been used to treat this problem have been ineffective and, consequently, surgery and physical therapy are the usual modes of treatment. The drug baclofen, injected intrathecally (into the spinal canal), has been successful in treating spasticity caused by a number of problems. This study examined the effects of intrathecal injections of baclofen in 23 patients with, aged 5 to 31 years. Group 1 included 17 children with congenital CP, and group 2 included 6 patients with spasticity caused by other problems, such as trauma. Four different dosages of baclofen were given (0, 25, 50, or 100 micrograms, or ug). Muscle tone was measured in the upper and lower extremities using the Ashworth scale. Results in group 1 revealed significant decreases in muscle tone in the lower extremities after injection with baclofen, but not in the upper extremities. Results were similar for all three dosages. Similar results were seen in group 2, although dosage significantly affected the amount of the decrease in lower extremity tone. Side effects were not observed when the 25 ug dose of baclofen was given, but when the 50 ug dose was administered two of the smaller children had reactions, including lethargy, disorientation and agitation. The results indicate that intrathecal injections of baclofen can be useful in treating spasticity in patients with CP. However, not all patients showed significant decreases in spasticity, and further research should be conducted to see if the drug provides relief for only certain patients with CP. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Physiological aspects, Cerebral palsy, Drug therapy, Spasticity, Baclofen

---

Hypothalamic hamartomas and sexual precocity: evaluation of treatment options

Article Abstract:

Hypothalamic hamartoma is a tumor-like nodule of superfluous tissue of the hypothalamus. The hypothalamus stimulates the pituitary gland, which stimulates the ovaries or testes, the glands which are capable of producing eggs or sperm, respectively. Hypothalamic hamartomas are known to be associated with sexual precocity. Better diagnostic tools, such as computed tomography (CT) and magnetic resonance imaging (MRI), are increasingly permitting identification of these patients. Because of these diagnostic developments and improvements in microsurgery, neurosurgical treatment of these patients may be considered. The cases of four boys with hypothalamic hamartoma and sexual precocity are described. The authors suggest that surgery is a valid option for treatment under the following conditions: the patient has normal adolescent endocrine make up; the hamartoma is on a stalk and thus easily resectable; and without surgery the patient would require years of parenteral medical treatment. Two of the four cases presented were treated surgically because medical treatment would have been required for almost 10 years. Surgery can cure the condition in certain cases. The reason to perform surgery is to stop the progression of puberty and premature bone development. It may not be necessary to treat the child surgically if onset of puberty is only slightly early, if the child adjusts satisfactorily to this early development, or if expected adult height will not be seriously affected. The best medical treatment, using gonadotropin-releasing hormone, requires parenteral administration, is expensive, and the long-term effects are not known. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Abnormalities, Diagnosis, Surgery, Hypothalamus, Precocious puberty, Hamartoma

---

Reversible suprasellar pituitary mass secondary to hypothyroidism

Article Abstract:

Three cases of children with primary hypothyroidism were examined with attention focusing on pituitary masses that had been detected with radiographic techniques. Hypothyroidism is a condition caused by deficient thyroid secretion and results in lowering basal metabolism. Some of the symptoms include low blood pressure, sluggishness, and obesity. Data derived from examination with MRI (magnetic resonance imaging) and CT scans (computerized tomography) were analyzed, along with the results of thyroid function tests. Sellar enlargement has been observed in conjunction with primary hypothyroidism in adults, but has been seen less often in children. In all three cases, growth abnormalities and symptoms of premature puberty were observed. These symptoms were ultimately linked with primary hypothyroidism. The sellar (the sella tursica is the location of the pituitary gland) enlargement and extension of the pituitary mass was alleviated as the pituitary gland returned to normal size after treatment with thyroid hormone. It was concluded that studies of the head were important in diagnosis and subsequent drug treatment which proved to be successful. Radiological techniques may have prevented surgery which would have been unnecessary in these three cases. It was recommended that, while no neurological deficits are apparent, success with thyroid hormone therapy can be achieved for patients with hypothyroidism.

Research, Prevention, Hypothyroidism, Medical imaging equipment, Surgery, Unnecessary, Unnecessary surgery, Pituitary gland, Pituitary gland tumors, Pituitary tumors

Similar abstracts:

• Abstracts: The cloacal malformation: radiologic findings and imaging recommendations. Apparent association between thymic cysts and prior thoracotomy
• Abstracts: Lymphocyte activity in the presence of peritoneal fluid from fertile woman and infertile women with and without endometriosis
• Abstracts: Pulmonary beta-adrenergic receptors and response do not mature precociously in growth-retarded rabbit fetuses
• Abstracts: The HIV epidemic and training in internal medicine: challenges and recommendations. part 2 Sexual harassment in medical training
• Abstracts: Cocaine and vasospasm. Relation between activated smooth-muscle cells in coronary-artery lesions and restenosis after atherectomy

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.