Spasticity can be very debilitating and painful. We present a case of severe spasticity from primary lateral sclerosis refractory to intrathecal baclofen in doses up to 1100 μg/d. Baclofen was weaned down and switched to intrathecal ziconotide at 0.6 μg/d. The dose was then titrated up to 3 μg/d with excellent control of spasticity. This case suggests that low-dose intrathecal ziconotide should be considered in patients with lower extremity spasticity refractory to intrathecal baclofen.
From the Department of Anesthesiology, Pain Management Center, University of Virginia Health System, Charlottesville, Virginia.
Accepted for publication December 31, 2018.
The authors declare no conflicts of interest.
Intrathecal ziconotide is not labeled for treating spasticity.
Address correspondence to Xiaoying Zhu, MD, PhD, Department of Anesthesiology, Pain Management Center, University of Virginia Health System, 545 Ray C. Hunt Dr, Suite 316, Charlottesville, VA 22903. Address e-mail to email@example.com.