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cannabinoids in different diseases and case reports on the use of cannabis by
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|Title||Treatment failure of intrathecal baclofen and supra-additive effect of nabiximols in multiple sclerosis-related spasticity: a case report.|
|Author(s)||Stroet A, Trampe N, Chan A.|
|Journal, Volume, Issue||Ther Adv Neurol Disord 2013;6(3):199-203.|
|Major outcome(s)||A combination of baclofen injections into the cerebrospinal fluid and very low doses of the cannabis extract Sativex was highly effective.|
Multiple sclerosis (MS)-related spasticity is associated with disability and impairment in quality of life. We report on a patient with secondary progressive MS and spastic tetraparesis (Expanded Disability Status Scale score 8.5). The right arm exhibited flexor spasticity resulting in functional disability despite multimodal symptomatic treatment. Intrathecal baclofen led to side effects despite decreasing efficacy. Low-dose nabiximols improved spasticity and function with recovery of daily-life activities and spasticity-related symptoms. Reduction of intrathecal baclofen ameliorated adverse drug reactions. Add-on cannabinoid therapy was effective in therapy-refractory spasticity with supra-additive effect in combining intrathecal baclofen and nabiximols, hypothetically explained by mutually complementing mechanisms of action.
|Participants||One patient with secondary progressive multiple sclerosis|
|Design||Uncontrolled case report|
|Type of publication||Medical journal|
|Address of author(s)||Department of Neurology, St Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, D-44791 Bochum, Germany.|