Children with cerebral palsy often have neurogenic bladders. Bladder function is further affected by complex medical management and multifactorial disease processes, leading to worsened function and poorer quality of life. Intrathecal baclofen (ITB) therapy has been used to treat hypertonia and spasticity, but implications in neurogenic bladder management have not been well described.
A 20-year-old female with a history of cerebral palsy and neurogenic bladder treated with sacral neuromodulation underwent ITB therapy and subsequently experienced improvement in bladder control, obviating the need for bladder stimulator use.
ITB improves hypertonia and can effectively obviate the need for neurostimulation to treat neurogenic bladder in patients with cerebral palsy. Further research is necessary to discern mechanisms. https://thejns.org/doi/10.3171/CASE24364.
Journal of neurosurgery. Case lessons. 2024 Oct 14*** epublish ***
Ryan K Wang, Victoria Jane Horak, Sunny Abdelmageed, Melissa A LoPresti, Maryam N Shahin, Benjamin Katholi, Jeffrey S Raskin
Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois., Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois., Department of Neurological Surgery, Division of Pediatric Neurosurgery, University of Rochester Medical Center, Rochester, New York., Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon., Department of Physiatry, Shirley Ryan Ability Lab, Chicago, Illinois.