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An 11-year old girl suffered a diffuse axonal injury after car accident. On admission, she was unconscious (GCS 4) and presented with brain contusion, pulmonary contusion, severe tetraparesis, spasticity and seizures. She did not respond to sedatives and anti-epileptic drugs. After 18 days at Intensive Care Unit, she was selected to baclofen screening. She received 100 microg of baclofen and her spasticity decreased and motor and sensor aphasia resolved.

Treatment of spasticity with intrathecal baclofen pump implantation is a chance for clinical improvement in patients with severe spasticity. It results also in improvement of patients and their families quality of life. The aim of study was to assess the effects after baclofen pump implantation due to parents expectations.The study was performed on a group of 17 parents which children have implantable baclofen pump. According to Assessment of Efficacy in Treatment Spasticity Questionaire was determined if the effects after pump implantation are satisfactory in parents opinion. There were done compartments of results from Questionaire, for which we can say about 1. good effects, 2. satisfactory effects, and 3. unsatifactory effects.In a group of 17 parents of children with implanted baclofen pump 10 assess that the effects after pump implantation are good, 5--effects are satisfactory and 2--effects are unsatisfactory. Parents noted substantial improvement in sleep and rest, in facilitating of body care, in reducing the pain and simplifies followed rehabilitation. Partial dissatifaction comed from excessive expectations due to terapeutical possibilities of the implantable baclofen pump.Intrathecal baclofen therapy brings essential benefits to patients and their families.

Spasticity is one from many clinical signs appearing in head and spinal cord injury and it is characterized by increased muscle tone with increased tendom reflex and reccurent spasms. Intrathecal baclofen therapy is surgical method for treatment of severe spasticity and a pump implantation is preceded by baclofen screening test. In this study we compared a bolus intrathecal injection given in a screening test with doses uses for filling a baclofen pump. In selected group we observed increased Baclofen dose due to dose given in screening test.