Intrathecal Baclofen (ITB) – Frequently Asked Questions

Neurosurgery

Spasticity Service

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What are the possible complications of ITB therapy?

• Underdose / Overdose of  Baclofen
• Infection of Pump or Catheter
• Infection of wound
• Catheter Kink (bent tubing) preventing the flow of baclofen
• Catheter disconnection – preventing baclofen from reaching the intrathecal space
• Pump malfunction

What are the signs of baclofen overdose?

• Slow or shallow breathing
• Drowsiness
• Light headedness
• Seizures
• ·Loss of consciousness

What are the signs of baclofen underdose?

• Itchiness
• High Temperature
• Confusion
• A sudden increase in spasticity
• Grumpiness or irritability

How long will the pump last for?

The battery in the pump has a life of 5-7 years. This means your child will need another operation to replace the pump.

What is my child able to do following pump implantation?

After surgery, your child can gradually return to all prior activities. Specific advice will be given to you and your physiotherapist. Before starting any new activities, it is advisable to discuss with your local physiotherapist, or at your next clinic appointment.

Will my child’s wheelchair need to be modified?

Straps or supports on your child’s wheelchair should not sit directly over the pump. This should be reviewed together with your community physio and wheelchair specialist.

Can my child go swimming after the pump is inserted?

Your child can go swimming approx. 4-6 weeks after the pump is implanted, as long as the wounds have healed. You will be advised about this when you attend hospital.

Can the pump be exposed to very hot / cold temperatures?

The pump is designed to tolerate a wide range of temperatures. It is fine to use hot / cold packs near to the pump. Spa Baths are fine, however Sauna’s should be avoided.

Can my child still travel abroad?

The pump is made of metal and will set off the alarm in Airport security. We will therefore give you a letter to take to the airport to explain the security staff about the pump. The scanner will not affect how the pump works.

Can my child have a scan or x-ray?

If your child needs an MRI (Magnetic Resonance Imaging), you must tell the medical imaging staff and the neurosurgical team at Alder Hey as soon as your appointment has been booked. The MRI scanners magnetic field will temporarily stop the pump’s motor from working and will stop the delivery of baclofen. Once the scan is finished, the pump will spontaneously restart, but it should be checked by someone from the neurosurgical team.

What if my child needs surgery after the pump is implanted?

It is important to tell the surgeon that ‘Monopolar cautery can interfere with the pump programme’. Ask the surgeon to contact the neurosurgical team at Alder Hey. If your child requires a lumbar puncture or an epidural, the neurosurgical team must be contacted first.

Will the ITB pump be affected by anything else?

The pump will not be affected by common household appliances (including microwaves, televisions, radios or mobile phones)

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

Please contact the neurosurgical team if:

Your child has a temperature higher than 38 degrees

• There is any redness or inflammation around the scar
• There is any swelling around the pump
• Your child is unusually drowsy
• Your child is unusually floppy
• Your child is unusually sweaty, itchy or grumpy
• You are concerned about the pump
• You hear a beeping noise coming from the pump.

Email: [email protected]; [email protected]

IN AN EMERGENCY Ward 4A: 0151 282 4489

This information can be made available in other languages and formats if requested.

PIAG: 209