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Baclofen is a muscle relaxant used to relieve the muscle spasms and pain associated with multiple sclerosis, cerebral palsy and other neurological disorders. It has side effects such as dizziness, sleepiness, nausea, vomiting and muscle weakness. The drug works directly on the central nervous system, but only a small amount gets past the blood-brain barrier when taken by mouth. Using an implanted pump to introduce the drug directly into the spinal canal, it is possible to achieve the same level of relief while using a much lower dose than would be taken orally.
The surgeon inserts a titanium pump and reservoir (slightly smaller than a hockey puck) into the patient's abdomen and runs the catheter under the skin and between two vertebrae in the lower back. The tip of the catheter continually dispenses baclofen into the cerebrospinal fluid-filled space around the spinal cord (the intrathecal space). The rate of baclofen delivery can be adjusted using a magnetic wand and the pump is refilled by injection. Patients taking baclofen should discuss any reduction in dose with their physicians. Sudden withdrawal from baclofen can cause cardiovascular instability, fever, and rash and requires emergency treatment.
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