Baclofen in community paediatric management of hypertonia

• Published in: Archives of disease in childhood Vol. 98; no. 2; p. 162
• Main Authors: Kumar, Ram, George, Binu
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.02.2013; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Audits; Baclofen; Baclofen - therapeutic use; Care and treatment; Cerebral Palsy; Child; Child Development; Community Health Services; Community Relations; Comorbidity; Data Analysis; Demographic aspects; Dosage and administration; Drug dosages; Drug Therapy; England; Guidelines; Humans; Muscle Hypertonia - drug therapy; Muscle pain; Muscle Relaxants, Central - therapeutic use; Narcotics; Neurodevelopment; Neurodisability; Neurology; Pain; Practice Guidelines as Topic; Retrospective Studies; Spasm; Spasms; Treatment Outcome; England
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2012-302818

Box 1 Oral drugs used in spasticity management-NICE recommendations 2 Initiation of treatment Diazepam Use if spasticity is contributing to discomfort/pain/muscle spasms/functional disability. The key recommendations for community paediatricians from our baseline audit complement the forthcoming NICE spasticity guidelines on the use of oral medications: (1) treatment goals should be clarified with parents, since baclofen may improve tone-related symptoms, such as pain, while worsening functions such as walking ability; (2) comorbidities that may limit tolerability, for instance, oropharyngeal weakness and GOR, which should be identified prior to initiating baclofen; and (3) review for adverse effects and achievement of treatment goals should guide dose titration and instituting alternative treatments (eg, diazepam).