This case presents a 35-year-old male with spinal predominant neurofibromatosis-1 who developed an incomplete spinal cord injury (C3 Asia C) which did not improve despite urgent decompressive surgery for multiple cervical neurofibromas. This report outlines a novel indication for intrathecal baclofen. The patient suffered from lower limb weakness with severe spasticity and required assistance of at least two for all activities. The aim of rehabilitation was to improve overall tone while focusing on independence, mobility and quality of life. After a successful trial of intrathecal baclofen, he underwent implantation of an intrathecal baclofen pump. The dose was gradually increased while he received a progressive programme of stretching and functional rehabilitation therapy. After 6 weeks, his MAS had improved to 1-2/4 and he had progressed to independent transfers, independence for most activities of daily living and was able to discharge to his family home with minimal support.
Keyphrases
- spinal cord injury
- lower limb
- spinal cord
- neuropathic pain
- study protocol
- multiple sclerosis
- healthcare
- botulinum toxin
- clinical trial
- coronary artery bypass
- early onset
- phase iii
- randomized controlled trial
- traumatic brain injury
- upper limb
- coronary artery disease
- open label
- atrial fibrillation
- stem cells
- acute coronary syndrome
- children with cerebral palsy