Document Detail


Successful intrathecal ethanol block for intractable spasticity of AIDS-related progressive multifocal leukoencephalopathy.
MedLine Citation:
PMID:  10432267     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study the efficacy of intrathecal ethanol block to relieve intractable spasticity in AIDS-related progressive multifocal leukoencephalopathy (PML) when long-term intrathecal baclofen infusion cannot be used.
METHODS: A 33-year-old man with AIDS-related PML developed very severe spastic paraparesis (Ashworth rigidity score, 4) and painful muscle spasms. The patient was unable to sit in his wheelchair and remained bed bound. Combined oral baclofen and tizanidine at therapeutical doses were used without any effect on the spasticity. The patient refused the placement of an intrathecal catheter for long-term baclofen infusion. A single intrathecal ethanol (6 ml) injection in the L2-L3 intervertebral space with the patient placed in a lateral Trendelenburg (40 C) position was performed.
RESULTS: The procedure was very effective in improving the stiffness (Ashworth rigidity score. 2, after the technique) and the muscle spasms disappeared. No side effects during or after the injection were observed.
CONCLUSION: Intrathecal ethanol block is a last but very useful choice for treatment of intractable spasticity in PML and other neurologic disorders in AIDS patients when other oral treatments have failed and intrathecal baclofen infusion is not suitable.
Authors:
V Asensi; J M Asensi; J A Carton; J A Maradona; M Oña; C Aréchaga
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Spinal cord     Volume:  37     ISSN:  1362-4393     ISO Abbreviation:  Spinal Cord     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-10-05     Completed Date:  1999-10-05     Revised Date:  2011-06-06    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  450-2     Citation Subset:  IM; X    
Affiliation:
Infectious Diseases Unit, Hospital Central de Asturias, Oviedo University Medical School, Spain.
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / complications*
Adult
Ethanol / therapeutic use*
Humans
Injections, Spinal
Leukoencephalopathy, Progressive Multifocal / complications*
Male
Muscle Spasticity / drug therapy*,  etiology
Chemical
Reg. No./Substance:
64-17-5/Ethanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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