Description

The intrathecal baclofen pump is a very useful tool in managing advanced spasticity in the adult and pediatric population, but it can also have a wide array of potential difficulties and complications.

The goal of this session is to discuss troubleshooting procedures and protocols to hopefully lead to increased comfort treating
this vulnerable patient population. These include:

1. The importance of an on call protocol in cases of withdrawal, from the ED to the neuro ICU.
2. Diagnostic tests to help determine if the baclofen pump and the catheter are properly functioning or not.
3. Treatment of acute baclofen withdrawal.
4. When to consult implanting surgeons in cases of malfunction of the pump.
5. Differential diagnosis of a loss of efficacy of the pump.

We appreciate that there is not a one size fit all solution to baclofen pump management, and that treating physicians work in a
wide array of environments. However, a discussion regarding these issues can help train the next generation of physiatrists to
be more comfortable treating this under treated patient population suffering from spasticity.

Learning Objectives

• Learning Objective 1: Feel more comfortable managing a potentially malfunctioning baclofen pump
• Learning Objective 2: Understand the different types of diagnostic tests to troubleshoot a potentially malfunctioning baclofen
• pump.
• Learning Objective 3: Have greater confidence building a team to manage patients with baclofen pumps

Member Community
Spasticity Management

Accreditation Statement
The American Academy of Physical Medicine and Rehabilitation is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation of Credit
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.  

Financial Disclosures
AAPM&R requires all individuals who are in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest, which is any entity producing, marketing, re-selling or distributing health care goods or services consumed by, or used on, patients. Disclosures are made in written form prior to the start of the educational activity and any potential conflicts of interest that exist are resolved prior to the start of the activity through AAPM&R’s Conflict of Interest Disclosure and Resolution Policy Process. Individuals in a position to control content and their disclosed financial relationships are listed below.

Faculty
Zachary Bohart, MD: Speaker's Bureau for Abbvie, Piramal Critical Care, and Medtronic. Research grants for Abbvie. 
Kimberly Heckert, MD: Honorarium for AAPM&R, Consluting/Advisory for Merz, Ipsen, AbbVie. Speaker's Bureau for Merz, Ipsen, AbbVie. Royalties from Springer Publishing.
Michael Saulino, MD, PhD: Speaker's Bureau for Ipsen. Advisory for Medtronic, Tersera, Abbvie, and Delphor. Research grants for Pacira. Section Editor for Interventional Pain Medicine.

AAPM&R Medical Education Committee
John C. Cianca, MD: Ownership or partnership with Musculoskeletal Ultrasound Consultants, LLC.
Karen P. Barr, MD: Disclosed no relevant financial relationships.
Rachel A. Brakke Holman, MD: Disclosed no relevant financial relationships.
Joseph E. Burris, MD: Serves on the Speakers Bureau for, and received clinical research grants from Allergan.
David S. Cheng, MD: Disclosed no relevant financial relationships.
Theresa A. Gillis, MD: Disclosed no relevant financial relationships.
Kevin N. Hakimi, MD: Disclosed no relevant financial relationships.
Matthew T. Haas, MD: Disclosed no relevant financial relationships.
R.Samuel Mayer, MD: Royalties from Demos Medical Publishing.
Ameet S. Nagpal, MD MS MEd: Disclosed no relevant financial relationships.
Sunil Sabharwal, MD: Royalities from Demos Publishing; board member, American Board of Physical Medicine and Rehabilitation.
Sarah M. Smith, MD: Disclosed no relevant financial relationships.
Stephanie Tow, MD: Disclosed no relevant financial relationships.
Kevin R. VIncent, MD, PhD: Disclosed no relevant financial relationships.

AAPM&R CME Committee
Karen P. Barr, MD: Disclosed no relevant financial relationships.
Cherry C. Junn, MD: Disclosed no relevant financial relationships.
Sheryl R. Levin, MD: Disclosed no relevant financial relationships.
Kentaro Onishi, DO: Disclosed no relevant financial relationships.
Evan R. Peck, MD: Disclosed no relevant financial relationships.
Cynthia G. Pineda, MD: Disclosed no relevant financial relationships.
Patricia T. Tan, MD: Disclosed no relevant financial relationships.
Brionn K. Tonkin, MD: Disclosed no relevant financial relationships.
Kristin A. Wong, MD: Disclosed no relevant financial relationships.

No other planners, faculty or other individuals in control of content disclosed any relevant financial relationships.

FDA Disclosures
All faculty members for this activity have disclosed they do not intend to discuss or demonstrate any pharmaceutical or medical device for which FDA clearance has not been approved.