STEP 2: Spasticity Live Course - April 26-27 in Rosemont, IL-Case-based Discussion: Multiple Sclerosis Quadriparesis Leading to Intrathecal Baclofen Disruption

Case-based Discussion: Multiple Sclerosis Quadriparesis Leading to Intrathecal Baclofen Disruption

Pdf Summary

Dr. Michael Saulino, a Chief in Physical Medicine and Rehabilitation, presented on troubleshooting intrathecal delivery systems through a case-based approach. The presentation highlights the current status of programmable intrathecal delivery systems, focusing on various devices. A case history of a 45-year-old man with spastic paraparesis due to PP-MS is detailed, showcasing his symptoms, treatments, functional status, and physical examination findings. His journey with intrathecal baclofen therapy, including the test dose, permanent implantation, and subsequent management, is discussed. <br /><br />The presentation delves into troubleshooting techniques for intrathecal delivery systems, such as radiograph appearances, catheter dye studies, CT myelogram dye studies, and nuclear medicine cisternograms. Methods for identifying issues like catheter fracture, migration, and occlusion are outlined, along with the advantages and limitations of each diagnostic procedure. For example, the catheter dye study offers improved sensitivity over plain films, while nuclear medicine cisternograms provide insights into flow rates and catheter volumes. <br /><br />Ultimately, the presentation emphasizes the importance of a thorough understanding of troubleshooting techniques for intrathecal delivery systems, especially in cases where patients experience episodic tone elevations or complications. By utilizing a case-based learning approach and diagnostic tools like radiographs and imaging studies, healthcare providers can effectively manage and address issues related to intrathecal delivery systems in patients undergoing intrathecal therapy for conditions such as spasticity.

Keywords

Dr. Michael Saulino

Physical Medicine and Rehabilitation

intrathecal delivery systems

programmable devices

spastic paraparesis

PP-MS

intrathecal baclofen therapy

troubleshooting techniques

radiograph appearances

nuclear medicine cisternograms