Dataset Information

Interaction between a smartphone and intrathecal baclofen pump case report.

ABSTRACT:

Introduction

Intrathecal Baclofen (ITB) is used for the treatment of spasticity. Pump complications are most commonly related to surgical implantation or catheter dysfunction. Less common complications include catheter access port dysfunction, motor failure from excessive wear on motor gear shafts, or a complete stall of the motor.

Case presentation

37-year-old with T9 motor complete paraplegia with ITB presented in baclofen withdrawal. Workup revealed that the pump's motor was not turning, requiring pump replacement. Questioning revealed that he had not undergone any MRI studies within the past six months, but that he recently purchased a new iPhone. The phone was 2-3 inches away from the pump for up to twelve hours a day, carried in a fanny pack around his waist.

Discussion

We present a case of motor pump failure from long term exposure to a magnetic field from a new iPhone. The ability of iPhones to overpower an ITB pump magnet is not widely known. In 2021, the Food and Drug Administration published a report regarding the effects of magnets in consumer electronics on implanted medical devices, recommending that such electronics should be kept at least 6 inches from the device. Providers should be aware of the ability of new models of commonly used electronic devices to stall the ITB motor to avoid life-threatening complications of baclofen withdrawal.

SUBMITTER: Filipetto F

PROVIDER: S-EPMC9988822 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Interaction between a smartphone and intrathecal baclofen pump case report.

Filipetto Francesca F Walden Judith J Trbovich Michelle M

Spinal cord series and cases 20230306 1

<h4>Introduction</h4>Intrathecal Baclofen (ITB) is used for the treatment of spasticity. Pump complications are most commonly related to surgical implantation or catheter dysfunction. Less common complications include catheter access port dysfunction, motor failure from excessive wear on motor gear shafts, or a complete stall of the motor.<h4>Case presentation</h4>37-year-old with T9 motor complete paraplegia with ITB presented in baclofen withdrawal. Workup revealed that the pump's motor was no ...[more]

PMID: 36879011

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Project description:BackgroundSevere spasticity may negatively impact functionality and quality of life after spinal cord injury (SCI). Intrathecal baclofen treatment (IBT) is effectively used to manage severe spasticity and reduce comorbidities. However, long-term IBT may have a negative effect on bone mineral content (BMC), bone mineral density (BMD) and body composition (such as percentage fat mass and lean body mass). We demonstrated the negative effects of long-term IBT use in a single case compared with two non-IBT users.Case summaryA 46-year old Caucasian male Veteran (case) with a 21 year history of complete tetraplegia (complete C6 SCI) was implanted with IBT for 20 years. The case was matched to two participants with different time since injuries [2 (match 1) and 13 (match 2) years] without IBT. Knee BMC and BMD at the epiphysis and metaphysis of the distal femur and proximal tibia were evaluated using dual knee and the dual femur modules of GE Lunar iDXA software. Total and leg body composition assessments were also conducted for the three participants. Potential effect of long-term IBT was demonstrated by changes in BMD, consistent with bone demineralization, at the distal femur and proximal tibia and changes in percentage fat mass and lean mass of legs. The case showed 113% lower BMD at the distal femur, and 78.1% lower at the proximal tibia compared to match 1, moreover the case showed 45% lower BMD at the distal femur, and no observed changes at the proximal tibia compared to match 2. The case had 27.1% and 16.5% greater leg %fat mass compared to match 1 and match 2, respectively. Furthermore, the case had 17.4% and 11.8% lower % leg lean mass compared to match 1 and match 2, respectively.ConclusionLong-term IBT may impact bone health and body composition parameters in persons with complete SCI. It may be prudent to encourage regular screening of individuals on long-term IBT considering the prevalence of osteoporosis related fractures, cardiovascular diseases, and metabolic disorders in this population.

Project description:AimTo investigate the effects of continuous intrathecal baclofen (ITB) therapy in children with cerebral palsy (CP) and other neurological conditions.MethodThis systematic review was conducted using standardized methodology, searching four electronic databases (PubMed, Embase, CINAHL, Cochrane Library) for relevant literature published between inception and September 2017. Included studies involved continuous ITB as an intervention and outcome measures relating to all International Classification of Functioning, Disability and Health: Children and Youth (ICF-CY) components.ResultsThirty-three studies were identified, of which one, including 17 children with spastic CP, produced level II evidence, and the others, mainly non-controlled cohort studies, level IV and V. Outcomes at body function level were most frequently reported. Results suggest continuous ITB may be effective in reducing spasticity and dystonia in CP, as well as other neurological conditions, and may improve the ease of care and quality of life of children with CP, but the level of evidence is low.InterpretationDespite three decades of applying ITB in children and a relatively large number of studies investigating the treatment effects, a direct link has not yet been demonstrated because of the low scientific quality of the primary studies. Further investigation into the effects of continuous ITB at all levels of the ICF-CY is warranted. Although large, controlled trials may be difficult to realize, national and international collaborations may provide opportunities. Also, multicentre prospective cohort studies with a long-term follow-up, employing harmonized outcome measures, can offer prospects to expand our knowledge of the effects of continuous ITB therapy in children.What this paper addsThere is low-level evidence for continuous intrathecal baclofen (ITB) in children with cerebral palsy. Continuous ITB is effective in reducing spasticity and dystonia in non-controlled cohort studies. Evaluation of individual goals and systematic assessment of long-term effects in large cohort studies are required.

Dataset Information

Interaction between a smartphone and intrathecal baclofen pump case report.

Introduction

Case presentation

Discussion

Publications

Interaction between a smartphone and intrathecal baclofen pump case report.

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