An unusual intrathecal baclofen pump failure thirteen months after implantation

TL;DR

A woman with multiple sclerosis experienced worsening spasticity due to an intrathecal baclofen pump failure thirteen months after implantation, highlighting the need for vigilance in monitoring such devices.

Contribution

This is the first reported case of verified intrathecal baclofen pump malfunction occurring within thirteen months of implantation.

Findings

Pump malfunction was identified as the cause of worsening spasticity after other possibilities were ruled out.

Urgent pump replacement restored therapeutic benefit and prevented complications.

Vigilance by the patient and healthcare providers ensured no adverse events occurred.

Abstract

To report a case of intrathecal pump failure following months of diminishing benefit from intrathecal baclofen, and to heighten awareness that intrathecal pump malfunction can occur without precipitating events.

A 40 year-old woman with multiple sclerosis and spastic paraplegia developed worsening spasticity after ten months of therapeutic stability with intrathecal baclofen. After other causes were pursued, this was discovered to be due to pump malfunction only thirteen months after implantation. After pump interrogation and discussion with the manufacturer the pump was replaced urgently and the patient regained therapeutic benefit and had no further complications.

We present herein what we believe to be the first report of a verified pump malfunction resulting in disruption of intrathecal baclofen delivery within thirteen months of implantation. Due to the possible severity of acute baclofen withdrawal, the pump was replaced urgently after diagnosis. Because of the patient's and her healthcare providers' vigilance, she experienced no adverse events. Healthcare providers are encouraged to acknowledge the possibility of intrathecal pump malfunction in similar scenarios, ensuring patient safety while systematically examining the underlying problem.

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