Spasticity, a common symptom accompanying
cerebral palsy (CP), can severely affect patients' function and cause disability in childhood. Intrathecal
baclofen (ITB)
therapy is a widely used treatment to reduce spasticity in quadriparetic CP patients. Likewise, adults sustaining
strokes and subsequent
spastic hemiplegic have proven excellent candidates as well from ITB
therapy. However, data on ITB treatment in pediatric patients with hemiplegic CP are lacking. This is the first report to present such a case. A nine-year old girl with
spastic hemiplegic CP failed chemical
denervation and serial casting of lower extremity spasticity and an associated
equinovarus contracture. An ITB bolus test revealed an improvement in her Ashworth score from a mean of 2.8 to 1.2 on the involved side, whereas the unaffected side stayed constant from a mean of 1.3 to 1.2. The patient was subsequently treated with continuous ITB with improvement of Ashworth scores from a mean of 2.8 at baseline to 1.1
at 17 months after implantation of the ITB pump. Subsequent surgery was performed to correct the residual ankle
deformity resulting in improvements in passive range of motion, gait function and
brace tolerance. Hemiplegic CP pediatric patients can be successfully treated with ITB to reduce spasticity, improve function, and retain postoperative surgical correction without affecting the normal side.