Local-spinal Therapy of Spasticity

1. Front Matter

   Pages I-VIII

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2. Preface

   1. Preface

      • H. Müller, J. Zierski, R. D. Penn

      Pages 1-2

3. A Short Historical Review of Spasticity and its Therapy

   1. A Short Historical Review of Spasticity and its Therapy

      • D. Dralle, H. Müller, J. Zierski

      Pages 3-16

4. Basic Experiences

   1. Front Matter

      Pages 17-17

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   2. Spinal Pharmacology of Agents which Alter Pain Transmission and Muscle Tone

      • T. L. Yaksh, P. A. C. Durant, M. S. Monasky, C. W. Stevens, R. R. Schick

      Pages 19-36

   3. The Neuropharmacology of Baclofen

      • W. Zieglgänsberger, J. R. Howe, B. Sutor

      Pages 37-49

   4. Animal Experiments on the Spinal Action of Midazolam

      • H. Gerlach, H. Müller, J. Boldt, G. Hempelmann

      Pages 51-64

   5. Intrathecal Injection of Antispastic Drugs in Rats: Muscle Relaxant Action of Midazolam, Baclofen, 2-Aminophosphonoheptanoic Acid (AP7) and Tizanidine

      • M. Schwarz, T. Klockgether, L. Turski, K.-H. Sontag

      Pages 65-79

   6. CSF Compatibility of Antispastic Agents

      • U. Börner, H. Müller, J. Zierski, G. Hempelmann, M. Reinacher

      Pages 81-84

   7. Dural Permeability to Bupivacaine, Baclofen and Midazolam: In Vitro Determination with Human Dura Mater

      • J. Biscoping, G. Michaelis, D. Friess, D. Krauß, E. Mutschler, G. Hempelmann

      Pages 85-90

5. Clinical Studies

   1. Front Matter

      Pages 91-91

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   2. Pharmacotherapy of Spasticity

      • J. Noth

      Pages 93-96

   3. Pumps in Pharmacotherapy

      • H. Müller, J. Zierski

      Pages 97-123

   4. Implantation of Ports and Pumps. Technique for Intrathecal Administration of Drugs

      • J. Zierski, H. Müller

      Pages 125-136

   5. Control of Spasticity with Intrathecal Morphine Sulfate

      • D. L. Erickson, P. Moreno, J. Lo, J. Cameron, M. Michaelson

      Pages 137-142

   6. Clinical Experience with Spinal Morphine, Midazolam and Tizanidine in Spasticity

      • H. Müller, J. Zierski

      Pages 143-150

   7. Chronic Intrathecal Baclofen for Severe Rigidity and Spasms

      • R. D. Penn

      Pages 151-153

   8. Intrathecal Baclofen in Spasticity

      • H. Müller, J. Zierski, D. Dralle, O. Hoffmann, G. Michaelis

      Pages 155-214

   9. Chronic Intrathecal Administration of Baclofen in Treatment of Severe Spasticity

      • Y. Lazorthes

      Pages 215-222

   10. Pharmacokinetics of Intrathecal Baclofen

       • H. Müller, J. Zierski, D. Dralle, D. Krauß, E. Mutschler

       Pages 223-226

Historical photograph of spinal anaesthesia In 1884 the American neurologist J. L. eases. His discovery, however, marks the Corning, by blocking the neural con­ onset of the era of regional anaesthesia. It took almost one hundred years until his duction to the hind extremities of a dog by injecting cocaine-solution into the lumbar original idea of "local medication of the vertebral interspace, was the first to per­ cord" was again reconsidered due to two form spinal (or epidural?) anaesthesia [1]. reasons: At that time, he was unaware of the local I. The discovery of different drug receptors anaesthetic properties of cocaine (dis­ in the spinal cord made it possible, by in­ covered in the same year by C. Koller, who trathecal injection (or epidural appli­ cation, if the drug penetrates the dura), applied cocaine to the eye of one of his pa­ tients [3]) and did not intend to introduce to alter nociceptive or motor transmis­ an anaesthetic procedure. Corning's pri­ sion within the spinal cord. mary aim was the application of drugs in 2. Implantable devices for long-term appli­ proximity of the central nervous system, i. e. cation of drugs to specific sites of the spinal cord, in order to treat or even heal body, including the spinal spaces, were developed during the 1970's.

• Infusion
• muscle
• neuropharmacology
• pain
• pharmacology
• pharmacotherapy
• rehabilitation
• spinal cord
• treatment

• Dept. Anesthesiology and Intensive Care Medicine, Justus-Liebig-University, Gießen, Germany

  Hermann Müller

• Dept. Neurosurgery, Justus-Liebig-University, Gießen, Germany

  Jan Zierski

• Dept. Neurosurgery, Rush-Presbyterian-St. Luke’s Medical Center Rush Medical College, Chicago, USA

  Richard D. Penn

Policies and ethics