BACKGROUND: Whenever oral treatment or botulinum toxin injections fail to control severe @entity508 , a trial with intrathecal @entity1772 is recommended no earlier than 1 year after @entity1545 . When irreversible contractures are to be avoided, such a trial might be done earlier. Some have briefly reported cognitive modifications with this treatment. METHODS: During the trial period, intrathecal @entity1772 is continuously infused by a portable external pump through an intrathecal catheter. The daily dose is adjusted according to the clinical response. If the expected response is obtained by reduction of @entity508 , a programmable pump is then implanted. Throughout the procedure, close neuropsychological follow-up is pursued. RESULTS: Two @entity1 with extremely severe @entity1545 and @entity508 received a programmable pump less than 10 months after @entity130 . Unexpectedly, one emerged from the minimally conscious state and the other from post-traumatic @entity2730 . CONCLUSIONS: Intrathecal @entity1772 should be considered within the first year after @entity1545 whenever @entity508 does not respond to medication. ITB lessens the degree of @entity508 which in turn facilitates care and, thus, has the potential to limit contractures. After severe @entity1545 , this treatment might trigger recovery from altered states of consciousness, improve cognition and facilitate rehabilitation.

Influence of intrathecal XXXX on the level of consciousness and mental functions after extremely severe traumatic brain injury: Brief report.

@entity1545 :: ('MESH:D020214', 'Disease') :: ['brain injury'] @entity1 :: ('9606', 'Species') :: ['persons'] @entity508 :: ('MESH:D009128', 'Disease') :: ['spasticity'] @entity2730 :: ('MESH:D000647', 'Disease') :: ['amnesia'] @entity1772 :: ('MESH:D001418', 'Chemical') :: ['baclofen'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity1772 :: (MESH:D001418,Chemical) :: ['baclofen']
