Disclosures: Natalia Miranda-Cantellops, MD: No financial relationships or conflicts of interest
Case Description: The patient was seen at outpatient clinic around 14 years after diagnosis of MS due to worsening spasticity affecting mostly the lower extremities and bladder and associated with increased muscular pain. After a successful trial, a baclofen pump was inserted.
Setting: Outpatient clinic
Patient: 57 y/o female with multiple sclerosis (MS) and cervical spine stenosis Assessment/
Results: Patient has undergone multiple MRIs due to her diagnosis of MS and cervical spine stenosis. Patient had a personal therapy manager (PTM) to give boluses as needed which was set by her managing physician. PTM devices used in pain medicine for optimizing pain control for each patient’s varying pain levels, but have not been frequently described in the literature for use in spasticity management. This patient not only used the PTM as needed to control any breakthrough spasticity but when she had MRIs done on two separate occasions the patient was able to interrogate her pump after the MRI and ensure recovery occurred after the stall without any complications. She was able to do this independently using the PTM without having to schedule an office appointment. Therefore, she did not have to coordinate an MRI on the day of clinic and drive several hours each time in order to ensure motor recovery.
Discussion: The Medtronics intrathecal baclofen pump is MRI compatible, but it is known motor stall occurs during an MRI, and interrogation is required to ensure recovery afterwards. Patients are always required to come into clinic after an MRI. However, this patient was able to use the PTM after every MRI to ensure recovery occurred without coming to clinic. This method of checking the pump after MRI allows patient flexibility without compromising safety.
Conclusion: PTM may be used in patients with intrathecal baclofen pumps to confirm motor recovery after MRI without coming into clinic, saving time and resources.
Level of Evidence: Level V
To cite this abstract in AMA style:
Miranda-Cantellops N, Rosales RA, khurana sR. A Novel Technique to Interrogate Intrathecal Baclofen Pump to Ensure Recovery After an MRI [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/a-novel-technique-to-interrogate-intrathecal-baclofen-pump-to-ensure-recovery-after-an-mri/. Accessed November 12, 2024.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-novel-technique-to-interrogate-intrathecal-baclofen-pump-to-ensure-recovery-after-an-mri/