Hi, in this poster, we will be discussing a novel technique to interrogate intrathecal baclofen pump to ensure recovery after an MRI. Here, we present a case of a 57-year-old female with history of multiple sclerosis and cervical spine stenosis who presented to a rehabilitation outpatient clinic 14 years after her diagnosis of multiple sclerosis due to worsening spasticity, mostly affecting her lower extremities and causing a spastic bladder. After a successful trial, a baclofen pump was inserted without any complications. The patient owned a personal therapy manager, or PTM, to give boluses to control any breakthrough spasticity that was said by her managing physician. Over the years, she has undergone multiple MRIs secondary to her diagnosis of MS and cervical spine stenosis. And on her PTM, she is able to interrogate the pump after MRI to ensure recovery of possible motor styling of the pump after MRI. Aspasticity is a frequent and disabling complication of MS that can interfere with daily activities and functionality. Baclofen is the most commonly prescribed medication to treat spasticity. It is a presynaptic GABA-B receptor agonist that decreases the influx of calcium and further reducing neurotransmitter release. Side effects from baclofen may include drowsiness, hypotension, headaches, and nausea. However, placement of an intrathecal baclofen pump is known to have less systemic effects as higher levels are reached in the CNS with lower doses. Patients with intrathecal baclofen pump require continuous outpatient follow-ups, mostly for dose adjustment and refills. However, another reason why patients may need to follow up is due to the possibility of pump failure, with motor styling after MRI, for which they have to go back to clinic each time for interrogation. However, this patient owns a PTM. These devices are used for optimizing chronic pain control by giving a patient additional boluses when needed with doses programmed by their physician. And they have not been frequently described in literature for spasticity management. However, this patient not only used the PTM as needed to control any breakthrough spasticity, but when she had MRIs done on two separate occasions, the patient was able to interrogate the pump after the MRI and ensure recovery occur after the stall without any complications. She is able to do this independently using her PTM without having to schedule an office appointment. Therefore, she did not have to coordinate an MRI on the same day of clinic and drive several hours each time to ensure motor recovery. Patients who understand the use of a PTM device and are conscious of withdrawal or overdose symptoms of baclofen may benefit from the use of a PTM machine, especially after an MRI to confirm that the baclofen pump is working. Therefore, sparing a clinic visit, thus saving time and health care resources. Further studies regarding assurance of adequate baclofen infusion need to be pursued. Thank you.

multiple sclerosis

cervical spine stenosis

baclofen pump

personal therapy manager

breakthrough spasticity