Intraventricular baclofen for dystonia: techniques and outcomes

Clinical article

Restricted access

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00


The aim of this study was to evaluate the use of intraventricular baclofen (IVB) for the treatment of severe generalized secondary and heredodegenerative dystonia.


Nine children and 1 adult with severe dystonia unresponsive to multiple oral medications were treated with IVB. Intraventricular catheters were positioned endoscopically in the third ventricle.


Eight of the 10 patients responded to IVB; their mean dystonia scores on the Barry-Albright dystonia scale decreased from 23 to 8. The 2 patients who did not respond had not responded to previous high doses of intrathecal baclofen. No adverse side effects related to IVB occurred. One child developed a pump infection that required pump removal, 1 developed a CSF infection that cleared after antibiotic administration, and 1 developed ventriculomegaly that required a shunt placement.


Intraventricular baclofen is an effective method of infusing baclofen to treat severe, generalized secondary dystonia, and, at times, heredodegenerative dystonia. The site of baclofen's activity when treating dystonia may be at the cortical level, and intraventricular infusion may result in higher baclofen concentrations over the cortex than intrathecal infusion. Additional studies are necessary to determine whether IVB is effective at lower doses than those used with intrathecal baclofen administration.

Abbreviations used in this paper: BAD = Barry-Albright dystonia; CP = cerebral palsy; DBS = deep brain stimulation; ITB = intrathecal baclofen; IVB = intraventricular baclofen; VP = ventriculoperitoneal.
Article Information

Contributor Notes

Address correspondence to: A. Leland Albright, M.D., Department of Neurosurgery, K4-836, University of Wisconsin Health Center, 600 Highland Avenue, Madison, Wisconsin 53792. email:
  • 1

    Albright ALPainter MJSchultz B: Infusion of intrathecal baclofen for generalized dystonia in cerebral palsy. J Neurosurg 88:73761998

    • Search Google Scholar
    • Export Citation
  • 2

    Albright ALBarry MJShafron DHFerson SS: Intrathecal baclofen for generalized dystonia. Dev Med Child Neurol 43:6526572001

  • 3

    Albright ALFerson SCarlos S: Occult hydrocephalus in children with cerebral palsy. Neurosurgery 56:93962005

  • 4

    Albright AL: Intraventricular baclofen infusion for dystonia. Report of two cases. J Neurosurg 1 Suppl105:71742006

  • 5

    Albright AL: Long-term intraventricular baclofen infusion in beagles. J Neurosurg 3 Suppl107:2252272007

  • 6

    Awaad YMunoz SNigro M: Progressive dystonia in a child with chromosome 18p deletion, treated with intrathecal baclofen. J Child Neurol 14:75771999

    • Search Google Scholar
    • Export Citation
  • 7

    Barry MJVanSwearingen JMAlbright AL: Reliability and responsiveness of the Barry-Albright Dystonia Scale. Dev Med Child Neurol 41:4044111999

    • Search Google Scholar
    • Export Citation
  • 8

    Brin MSadiq SGoodman RFord BPerez EFahn S: Intrathecal baclofen (IT-B) for dystonia. Neurology 44:1141 11421994

  • 9

    Dachy BDan B: Electrophysiological assessment of the effect of intrathecal baclofen in dystonic children. Clin Neurophysiol 115:7747782004

    • Search Google Scholar
    • Export Citation
  • 10

    Dalvi AFahn SFord B: Intrathecal baclofen in the treatment of dystonic storm. Mov Disord 13:6116121998

  • 11

    Diederich NJComella CLMatge GBecker GSchlitz FMetz H: Sustained effect of high-dose intrathecal baclofen in primary generalized dystonia: a 2-year follow-up study. Mov Disord 12:110011021997

    • Search Google Scholar
    • Export Citation
  • 12

    Dressler DOeljeschlager RORuther E: Severe tardive dystonia: treatment with continuous intrathecal baclofen administration. Mov Disord 12:5855871997

    • Search Google Scholar
    • Export Citation
  • 13

    Ford BGreene PLouis EDPetzinger GBressman SBGoodman R: Use of intrathecal baclofen in the treatment of patients with dystonia. Arch Neurol 53:124112461996

    • Search Google Scholar
    • Export Citation
  • 14

    Mariotti PFasano AContarino FDella Marca GPiastra MGenovese O: Management of status dystonicus: our experience and review of the literature. Mov Disord 22:963 9682007

    • Search Google Scholar
    • Export Citation
  • 15

    Narayan RKLoubser PGJankovic JDonovan WHBontke CF: Intrathecal baclofen for intractable axial dystonia. Neurology 41:114111421991

    • Search Google Scholar
    • Export Citation
  • 16

    Paret GTirosh RBen Zeev BVardi ABrandt NBarzilay A: Intrathecal baclofen for severe torsion dystonia in a child. Acta Paediatr 85:6356371996

    • Search Google Scholar
    • Export Citation
  • 17

    Penn RDGianino JMYork MM: Intrathecal baclofen for motor disorders. Mov Disord 10:6756771995

  • 18

    Roig MCalopa MRovira AMacaya ARiudor ELosada M: Bilateral striatal lesions in childhood. Pediatr Neurol 9:3493581993

  • 19

    Siebner HRDressnandt JAuer CConrad B: Continuous intrathecal baclofen infusions induced a marked increase of the transcranially evoked silent period in a patient with generalized dystonia. Muscle Nerve 21:120912121998

    • Search Google Scholar
    • Export Citation
  • 20

    Woon KTsegaya MVloeberghs MH: The role of intrathecal baclofen in the management of primary and secondary dystonia in children. Br J Neurosurg 21:3553582007

    • Search Google Scholar
    • Export Citation


All Time Past Year Past 30 Days
Abstract Views 289 183 19
Full Text Views 212 42 1
PDF Downloads 148 32 1
EPUB Downloads 0 0 0
Google Scholar