. "Intrat\u00E9k\u00E1ln\u011B podan\u00FD baklofen pumpov\u00FDmi syst\u00E9my je metodou volby u nemocn\u00FDch s t\u011B\u017Ekou generalizovanou spasticitou, u nich\u017E jsou jin\u00E9 l\u00E9\u010Debn\u00E9 mo\u017Enosti vy\u010Derp\u00E1ny. Prezentujeme \u00FAsp\u011B\u0161n\u00E9 v\u00FDsledky desetilet\u00E9 l\u00E9\u010Dby t\u011B\u017Ek\u00E9 generalizovan\u00E9 spasticity pomoc\u00ED baklofenov\u00E9 pumpy u nemocn\u00E9 s roztrou\u0161enou skler\u00F3zou. Materi\u00E1l a metodika: Osmapades\u00E1tilet\u00E1 pacientka se sekund\u00E1rn\u011B progresivn\u00ED formou roztrou\u0161en\u00E9 skler\u00F3zy byla posl\u00E1na do na\u0161\u00ED ambulance k l\u00E9\u010Db\u011B t\u011B\u017Ek\u00E9 spasticity doln\u00EDch kon\u010Detin. Diagn\u00F3za roztrou\u0161en\u00E9 skler\u00F3zy byla stanovena z typick\u00E9ho klinick\u00E9ho obrazu, n\u00E1lezu na magnetick\u00E9 rezonanci a n\u00E1lezu v likvoru. V dob\u011B testov\u00E1n\u00ED intrat\u00E9k\u00E1ln\u011B podan\u00E9ho baklofenu m\u011Bla pacientka EDSS 7. U\u017E\u00EDvala vysok\u00E9 d\u00E1vky peror\u00E1ln\u00EDch antispastick\u00FDch l\u00E9k\u016F. Po pozitivn\u00ED odpov\u011Bdi na intrat\u00E9k\u00E1ln\u011B podan\u00FD baklofen byla provedena prvn\u00ED implantace pumpy (Synchromed EL, Medtronic) v roce 2004 s velmi dobr\u00FDm efektem na sn\u00ED\u017Een\u00ED svalov\u00E9ho hypertonu a zm\u00EDrn\u011Bn\u00ED frekvence svalov\u00FDch spazm\u016F. Po \u010Dty\u0159ech letech od implantace do\u0161lo n\u00E1hle k ucp\u00E1n\u00ED kat\u00E9tru a byla nutn\u00E1 jeho v\u00FDm\u011Bna. V dob\u011B kon\u010D\u00EDc\u00ED \u017Eivotnosti gener\u00E1toru pumpy byla po v\u00EDce ne\u017E p\u011Bti letech od implantace provedena v\u00FDm\u011Bna za novou pumpu (Synchromed II, Medtronic). Pacientka je dlouhodob\u011B spokojen\u00E1 na d\u00E1vce 125 \u03BCg baklofenu denn\u011B. EDSS m\u00E1 nyn\u00ED 7,5. Z\u00E1v\u011Br: U nemocn\u00FDch, kter\u00E9 t\u011B\u017Ek\u00E1 generalizovan\u00E1 spasticita limituje v sebeobsluze i v b\u011B\u017En\u00FDch denn\u00EDch \u010Dinnostech, je intrat\u00E9k\u00E1ln\u00ED l\u00E9\u010Dba kontinu\u00E1ln\u00EDm baklofenem metodou volby. Stabilizovan\u00FD stav na\u0161\u00ED pacientky s roztrou\u0161enou skler\u00F3zou i po 10 letech od za\u010D\u00E1tku l\u00E9\u010Dby je toho dokladem. Komplikace, kter\u00E9 se v pr\u016Fb\u011Bhu l\u00E9\u010Dby mohou vyskytnout, jsou v\u011Bt\u0161inou m\u00E9n\u011B v\u00FDznamn\u00E9 a snadno \u0159e\u0161iteln\u00E9." . . "Dlouhodob\u00E1 l\u00E9\u010Dba intrat\u00E9k\u00E1ln\u00EDm baklofenem u pacientky s roztrou\u0161enou skler\u00F3zou \u2013 kazuistika"@cs . "1"^^ . "[05332B90C470]" . . . "Dlouhodob\u00E1 l\u00E9\u010Dba intrat\u00E9k\u00E1ln\u00EDm baklofenem u pacientky s roztrou\u0161enou skler\u00F3zou \u2013 kazuistika" . "76" . . "http://www.prolekare.cz/dokumenty/j48_2013_csnn_supplementum.pdf" . "Long-Term Treatment with Intrathecal Baclofen in a Multiple Sclerosis Patient - a Case Report"@en . "Dlouhodob\u00E1 l\u00E9\u010Dba intrat\u00E9k\u00E1ln\u00EDm baklofenem u pacientky s roztrou\u0161enou skler\u00F3zou \u2013 kazuistika"@cs . "RIV/00216208:11120/13:43907558!RIV14-MZ0-11120___" . "3"^^ . . "Intrathecal baclofen (ITB) delivered by programmable pump devices represents an important treatment modality for severe spasticity when other treatment modalities have an insufficient effect. In this paper, we report excellent clinical outcomes after ten years of ITB treatment in a multiple sclerosis patient. Material and methods: A 58-year-old female with clinically definite multiple sclerosis in secondary progression was referred to our neurological department for treatment of severe spasticity of the lower extremities. The final diagnosis was based on the typical clinical status, magnetic resonance (MRI) findings and oligoclonal antibodies in the cerebrospinal fluid. At the time of ITB testing, the MS patient had EDSS of 7. She was treated with a high-dose antispasmodic medication. After positive clinical response to ITB bolus, she underwent pump implantation (Synchromed EL, Medtronic) in 2004 with very good effect on spasticity and decreased frequency of muscle spasms. After four years of implantation, she experienced catheter malfunction resulting in its reimplantation. At the end of battery life after five years from the first implantation, the patient underwent pump reimplantation (Synchromed II, Medtronic). The patient is satisfied and tolerates the total daily dose of 125 \u03BCg of baclofen well. Her current EDSS is 7.5. Conclusion: Intrathecal baclofen delivery is a good treatment option in patients with severe generalized spasticity that limits activities of daily living as shown in our MS patient who has been stable for 10 years of ITB treatment. Complications of ITB are less important and usually well treatable"@en . . . "Dlouhodob\u00E1 l\u00E9\u010Dba intrat\u00E9k\u00E1ln\u00EDm baklofenem u pacientky s roztrou\u0161enou skler\u00F3zou \u2013 kazuistika" . "CZ - \u010Cesk\u00E1 republika" . . "\u0160t\u011Btk\u00E1\u0159ov\u00E1, Ivana" . "Long-Term Treatment with Intrathecal Baclofen in a Multiple Sclerosis Patient - a Case Report"@en . "70092" . . "11120" . "1210-7859" . . "baclofen pump; intrathecal baclofen; spasticity; multiple sclerosis"@en . "000325235000005" . . "I, P(NT12282)" . . "RIV/00216208:11120/13:43907558" . . "Suppl. 1" . "\u010Cesk\u00E1 a slovensk\u00E1 neurologie a neurochirurgie" . . . "Intrat\u00E9k\u00E1ln\u011B podan\u00FD baklofen pumpov\u00FDmi syst\u00E9my je metodou volby u nemocn\u00FDch s t\u011B\u017Ekou generalizovanou spasticitou, u nich\u017E jsou jin\u00E9 l\u00E9\u010Debn\u00E9 mo\u017Enosti vy\u010Derp\u00E1ny. Prezentujeme \u00FAsp\u011B\u0161n\u00E9 v\u00FDsledky desetilet\u00E9 l\u00E9\u010Dby t\u011B\u017Ek\u00E9 generalizovan\u00E9 spasticity pomoc\u00ED baklofenov\u00E9 pumpy u nemocn\u00E9 s roztrou\u0161enou skler\u00F3zou. Materi\u00E1l a metodika: Osmapades\u00E1tilet\u00E1 pacientka se sekund\u00E1rn\u011B progresivn\u00ED formou roztrou\u0161en\u00E9 skler\u00F3zy byla posl\u00E1na do na\u0161\u00ED ambulance k l\u00E9\u010Db\u011B t\u011B\u017Ek\u00E9 spasticity doln\u00EDch kon\u010Detin. Diagn\u00F3za roztrou\u0161en\u00E9 skler\u00F3zy byla stanovena z typick\u00E9ho klinick\u00E9ho obrazu, n\u00E1lezu na magnetick\u00E9 rezonanci a n\u00E1lezu v likvoru. V dob\u011B testov\u00E1n\u00ED intrat\u00E9k\u00E1ln\u011B podan\u00E9ho baklofenu m\u011Bla pacientka EDSS 7. U\u017E\u00EDvala vysok\u00E9 d\u00E1vky peror\u00E1ln\u00EDch antispastick\u00FDch l\u00E9k\u016F. Po pozitivn\u00ED odpov\u011Bdi na intrat\u00E9k\u00E1ln\u011B podan\u00FD baklofen byla provedena prvn\u00ED implantace pumpy (Synchromed EL, Medtronic) v roce 2004 s velmi dobr\u00FDm efektem na sn\u00ED\u017Een\u00ED svalov\u00E9ho hypertonu a zm\u00EDrn\u011Bn\u00ED frekvence svalov\u00FDch spazm\u016F. Po \u010Dty\u0159ech letech od implantace do\u0161lo n\u00E1hle k ucp\u00E1n\u00ED kat\u00E9tru a byla nutn\u00E1 jeho v\u00FDm\u011Bna. V dob\u011B kon\u010D\u00EDc\u00ED \u017Eivotnosti gener\u00E1toru pumpy byla po v\u00EDce ne\u017E p\u011Bti letech od implantace provedena v\u00FDm\u011Bna za novou pumpu (Synchromed II, Medtronic). Pacientka je dlouhodob\u011B spokojen\u00E1 na d\u00E1vce 125 \u03BCg baklofenu denn\u011B. EDSS m\u00E1 nyn\u00ED 7,5. Z\u00E1v\u011Br: U nemocn\u00FDch, kter\u00E9 t\u011B\u017Ek\u00E1 generalizovan\u00E1 spasticita limituje v sebeobsluze i v b\u011B\u017En\u00FDch denn\u00EDch \u010Dinnostech, je intrat\u00E9k\u00E1ln\u00ED l\u00E9\u010Dba kontinu\u00E1ln\u00EDm baklofenem metodou volby. Stabilizovan\u00FD stav na\u0161\u00ED pacientky s roztrou\u0161enou skler\u00F3zou i po 10 letech od za\u010D\u00E1tku l\u00E9\u010Dby je toho dokladem. Komplikace, kter\u00E9 se v pr\u016Fb\u011Bhu l\u00E9\u010Dby mohou vyskytnout, jsou v\u011Bt\u0161inou m\u00E9n\u011B v\u00FDznamn\u00E9 a snadno \u0159e\u0161iteln\u00E9."@cs . "1"^^ . . .