Intrathecal baclofen treatment in children with neurological disorders
Bonouvrié, L.A.
2019
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citation for published version (APA)
Bonouvrié, L. A. (2019). Intrathecal baclofen treatment in children with neurological disorders.
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SAMENVATTING
ĞƌĞďƌĂůĞďĞǁĞŐŝŶŐƐƐƚŽŽƌŶŝƐƐĞŶŽŵǀĂƩĞŶĞĞŶďƌĞĞĚƐƉĞĐƚƌƵŵĂĂŶƵŝƫŶŐƐǀŽƌŵĞŶ ǁĂĂƌďŝũŽŽŬĚĞĞƌŶƐƚĞƌŐƵŝƚĞĞŶůŽƉĞŶĚŝƐ͘ŝƚƉƌŽĞĨƐĐŚƌŝŌƌŝĐŚƚnjŝĐŚŽƉĞƌŶƐƟŐĂĂŶŐĞĚĂŶĞ ŬŝŶĚĞƌĞŶ͘ŝƚnjŝũŶŬŝŶĚĞƌĞŶŵĞƚĐĞƌĞďƌĂůĞƉĂƌĞƐĞ;WͿĚŝĞŐĞĐůĂƐƐŝĮĐĞĞƌĚǁŽƌĚĞŶŽƉĚĞ 'ƌŽƐƐDŽƚŽƌ&ƵŶĐƟŽŶŝŶŐůĂƐƐŝĮĐĂƟŽŶ^LJƐƚĞŵ;'D&^ͿŝŶŶŝǀĞĂƵ/sĞŶs͕ŽĨŬŝŶĚĞƌĞŶ ŵĞƚƉƌŽŐƌĞƐƐŝĞǀĞŶĞƵƌŽůŽŐŝƐĐŚĞĂĂŶĚŽĞŶŝŶŐĞŶ;WEͿĚŝĞŶĞƚnjŽĞƌŶƐƟŐĂĂŶŐĞĚĂĂŶ njŝũŶŝŶŚƵŶŵŽƚŽƌŝƐĐŚĨƵŶĐƟŽŶĞƌĞŶ͘ĞnjĞŬŝŶĚĞƌĞŶŬƵŶĞŶŶŝĞƚnjĞůĨƐƚĂŶĚŝŐůŽƉĞŶ͕ŽĨ ŬƵŶŶĞŶŚĞůĞŵĂĂůŶŝĞƚůŽƉĞŶ͕ĞŶŐĞďƌƵŝŬĞŶǀŽŽƌŶĂŵĞůŝũŬĞĞŶ;ĞůĞŬƚƌŝƐĐŚĞͿƌŽůƐƚŽĞůǀŽŽƌ mobiliteit. ĞǁĞŐŝŶŐƐƐƚŽŽƌŶŝƐƐĞŶďŝũŬŝŶĚĞƌĞŶǁŽƌĚĞŶǀŽŽƌŶĂŵĞůŝũŬǀĞƌŽŽƌnjĂĂŬƚĚŽŽƌĚLJƐĨƵŶĐƟĞ ǀĂŶŚĞƚŝŶŽŶƚǁŝŬŬĞůŝŶŐnjŝũŶĚĞďƌĞŝŶĚŽŽƌďĞƐĐŚĂĚŝŐŝŶŐĞŶŽĨĂĂŶůĞŐƐƚŽŽƌŶŝƐƐĞŶ͘Ğ /ŶƚĞƌŶĂƟŽŶĂůůĂƐƐŝĮĐĂƟŽŶŽĨ&ƵŶĐƟŽŶŝŶŐ͕ĚŝƐĂďŝůŝƚLJĂŶĚŚĞĂůƚŚĨŽƌŚŝůĚƌĞŶĂŶĚzŽƵƚŚ ;/&ͲzͿŬĂŶŐĞďƌƵŝŬƚǁŽƌĚĞŶĂůƐŬĂĚĞƌŽŵĚĞĐŽŵƉůĞdžŝƚĞŝƚǀĂŶƉƌŽďůĞŵĞŶĚŝĞŽƉƚƌĞĚĞŶ ďŝũĐĞƌĞďƌĂůĞďĞǁĞŐŝŶŐƐƐƚŽŽƌŶŝƐƐĞŶƚĞŽŵǀĂƩĞŶ͘Ğ/&ͲzŵĂĂŬƚǀĞƌďŝŶĚŝŶŐƚƵƐƐĞŶ ŚĞƚŶŝǀĞĂƵǀĂŶůŝĐŚĂĂŵƐĨƵŶĐƟĞƐĞŶƐƚƌƵĐƚƵƌĞŶ;ďŝũǀ͘ƐƉĂƐƟĐŝƚĞŝƚŽĨĚLJƐŬŝŶĞƐŝĞͿ͕ǁĞůŬĞ ŬƵŶŶĞŶ ůĞŝĚĞŶ ƚŽƚ ƉƌŽďůĞŵĞŶ ŽƉ ŚĞƚ ŐĞďŝĞĚ ǀĂŶ ĂĐƟǀŝƚĞŝƚĞŶ ŝŶ ŚĞƚ ĚĂŐĞůŝũŬƐ ůĞǀĞŶ ŽĨƉĂƌƟĐŝƉĂƟĞŝŶĚĞŵĂĂƚƐĐŚĂƉƉŝũnjŽĂůƐŵŽďŝůŝƚĞŝƚ͕njĞůĨǀĞƌnjŽƌŐŝŶŐ͕ĐŽŵŵƵŶŝĐĂƟĞĞŶ ůĞĞƌǀĂĂƌĚŝŐŚĞŝĚ͘ĐƟǀŝƚĞŝƚĞŶĞŶƉĂƌƟĐŝƉĂƟĞŬƵŶĞŶĚĂĂƌŶĂĂƐƚŶŽŐǁŽƌĚĞŶďĞŢŶǀůŽĞĚ ĚŽŽƌ ŽŵŐĞǀŝŶŐƐĨĂĐƚŽƌĞŶ͕ ǁĂĂƌŽŶĚĞƌ ĚĞ ďĞƐĐŚŝŬďĂĂƌŚĞŝĚ ǀĂŶ ŚƵůƉ ďŝũ ƉĞƌƐŽŽŶůŝũŬĞ verzorging en hulpmiddelen voor mobiliteit.ϭϴϳ
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ĞŶƟũĚĞŶƐŐĞďůŝŶĚĞĞƌĚĞďĞŚĂŶĚĞůŝŶŐŵĞƚ/dŽĨƉůĂĐĞďŽ͘^ĞĐƵŶĚĂŝƌĞƵŝƚŬŽŵƐƚŵĂƚĞŶ ǁĂƌĞŶĚLJƐƚŽŶŝĞ;ĂƌƌLJͲůďƌŝŐŚƚͲLJƐƚŽŶŝĂ^ĐĂůĞ;^ͿͿ͕ƉŝũŶ;s^Ϳ͕ĞŶĐŽŵĨŽƌƚ;s^Ϳ͘ ,ĞƚŬůŝŶŝƐĐŚƐŝŐŶŝĮĐĂŶƚĞǀĞƌƐĐŚŝůǁĞƌĚďĞŽŽƌĚĞĞůĚ͘ŽǁĞůƉƌŽďůĞŵĞŶŝŶŚĞƚĚĂŐĞůŝũŬƐ ůĞǀĞŶĂůƐĚLJƐƚŽŶŝĞǀĞƌďĞƚĞƌĚĞŶďŝũĂůůĞƉĂƟģŶƚĞŶƟũĚĞŶƐĚĞƉƌŽĞĩĞŚĂŶĚĞůŝŶŐ͘WŝũŶ ĞŶĐŽŵĨŽƌƚǀĞƌďĞƚĞƌĚĞŶďŝũƚǁĞĞƉĂƟģŶƚĞŶĞŶǀĞƌƐůĞĐŚƚĞƌĚĞďŝũĠĠŶ͘dŝũĚĞŶƐĚĞƉŝůŽƚ ǁĂƌĞŶĞƌĞŶŬĞůĞƐĞƌŝĞƵnjĞĐŽŵƉůŝĐĂƟĞƐ͕ǁĂĂƌĚŽŽƌďĞƚƌŽƵǁďĂƌĞďĞŽŽƌĚĞůŝŶŐƟũĚĞŶƐĚĞ ŐĞďůŝŶĚĞĞƌĚĞĨĂƐĞŵŽĞŝůŝũŬǁĂƐ͘KŶĚĂŶŬƐĚĞnjĞďĞƉĞƌŬŝŶŐĞŶĚĞďĞƉĞƌŬƚĞďĞǁŝũƐŬƌĂĐŚƚ van deze studie, waren de resultaten veelbelovend genoeg om een klinische trial te starten.ϭϴϴ ŬůŝŶŝƐĐŚĞŽďƐĞƌǀĂƟĞƐĐŚĂůĞŶǀŽŽƌŚĞƚƐĐŽƌĞŶǀĂŶĚLJƐƚŽŶŝĞnjŝũŶŵŽŐĞůŝũŬďĞƉĞƌŬƚŝŶŚĞƚ ŐĞďƌƵŝŬ ĚŽŽƌ ĚĞ ŶŽŐ ŽŶďĞŬĞŶĚĞ ƚĞƐƚͲŚĞƌƚĞƐƚ ďĞƚƌŽƵǁďĂĂƌŚĞŝĚ͘ ƌ ŝƐ ďĞŚŽĞŌĞ ĂĂŶ ďĞƚƌŽƵǁďĂĂƌĚĞƌĞƵŝƚŬŽŵƐƚŵĂƚĞŶŽŵǀĞƌĂŶĚĞƌŝŶŐĞŶŝŶĚLJƐƚŽŶŝĞďŝũƉĂƟģŶƚĞŶŵĞƚ/d te meten. ,ŽŽĨĚƐƚƵŬϲŐĞĞŌĚĞƌĞƐƵůƚĂƚĞŶǁĞĞƌǀĂŶĞĞŶƐLJƐƚĞŵĂƟƐĐŚĞůŝƚĞƌĂƚƵƵƌƐƚƵĚŝĞŶĂĂƌ ŚĞƚĞīĞĐƚǀĂŶ/dďŝũƉĂƟģŶƚĞŶŵĞƚWEŝŶĚĞŬŝŶĚĞƌƟũĚ͘/ŶƚŽƚĂĂůnjŝũŶnjĞƐƐƚƵĚŝĞƐ ŐĞǀŽŶĚĞŶ͘ sŝũĨ ǁĂƌĞŶ ĐĂƐĞ ƌĞƉŽƌƚƐ ĞŶ ĠĠŶ ǁĂƐ ĞĞŶ ĐĂƐĞ ƐĞƌŝĞ͘ Ğ ďĞǁŝũƐŬƌĂĐŚƚ ŝƐ ĚĞƌŚĂůǀĞůĂĂŐ͘hŝƚŬŽŵƐƚŵĂƚĞŶǁĂƌĞŶǀŽŽƌŶĂŵĞůŝũŬŽƉŚĞƚŶŝǀĞĂƵǀĂŶůŝĐŚĂĂŵƐĨƵŶĐƟĞƐ ĞŶƐƚƌƵĐƚƵƌĞŶ͘^ƉĂƐƟĐŝƚĞŝƚǁĞƌĚŝŶĚƌŝĞƐƚƵĚŝĞƐŽďũĞĐƟĞĨŐĞŵĞƚĞŶĞŶǀĞƌďĞƚĞƌĚĞŝŶ ĂůĚĞnjĞƐƚƵĚŝĞƐƟũĚĞŶƐ/d͘ĂĂƌŶĂĂƐƚǁĞƌĚŐĞƌĂƉƉŽƌƚĞĞƌĚĚĂƚƉŝũŶǀĞƌŵŝŶĚĞƌĚ͘KƉ ŚĞƚŶŝǀĞĂƵǀĂŶĂĐƟǀŝƚĞŝƚĞŶĞŶƉĂƌƟĐŝƉĂƟĞǁĞƌĚĞŶŐĞĞŶƐƚƌƵĐƚƵƌĞůĞƵŝƚŬŽŵƐƚŵĂƚĞŶ ŐĞďƌƵŝŬƚ͘^ƵďũĞĐƟĞǀĞǀĞƌďĞƚĞƌŝŶŐǀĂŶŬůĞĚĞŶ͕ŚLJŐŝģŶŝƐĐŚĞǀĞƌnjŽƌŐŝŶŐĞŶƉŽƐŝƟŽŶĞƌĞŶ in een rolstoel werd beschreven.
ĠŶ ǀĂŶ ĚĞ ƐƚƵĚŝĞƐ ŐĞŢŶĐůƵĚĞĞƌĚ ŝŶ ŚĞƚ ƌĞǀŝĞǁ ŝŶ ŚŽŽĨĚƐƚƵŬ Ϯ ƌĂƉƉŽƌƚĞĞƌƚ ĚĞ ƚĞǀƌĞĚĞŶŚĞŝĚŽǀĞƌ/dďŝũnjĞƐƉĂƟģŶƚĞŶŵĞƚWE͘ŝƚŽŶĚĞƌnjŽĞŬƐƚĂĂƚďĞƐĐŚƌĞǀĞŶŝŶ ŚŽŽĨĚƐƚƵŬϳ͘ĞŐĞŵŝĚĚĞůĚĞĨŽůůŽǁƵƉƟũĚǀĂŶĚĞnjĞƉĂƟģŶƚĞŶǁĂƐϯ͘ϯũĂĂƌ;^Ϯ͘ϵͿ͘ KƵĚĞƌƐ ǁĞƌĚ ŐĞǀƌĂĂŐĚ ŽĨ njŝũ ƚĞǀƌĞĚĞŶ ǁĂƌĞŶ ŵĞƚ /d ;ũĂͬŶĞĞͬĚĞĞůƐͿ ĞŶ ŽĨ njĞ ĞĞŶ ƌĂƉƉŽƌƚĐŝũĨĞƌ;s^ͿŬŽŶĚĞŶŐĞǀĞŶǀŽŽƌŚƵŶƚĞǀƌĞĚĞŶŚĞŝĚǀĂŶϬ;ƐůĞĐŚƚƐƚĞƐĐŽƌĞͿƚŽƚϭϬ ;ďĞƐƚĞƐĐŽƌĞͿ͘sŝĞƌŽƵĚĞƌƐŐĂǀĞŶĂĂŶƚĞǀƌĞĚĞŶƚĞnjŝũŶŵĞƚ/d͕ĞĞŶǁĂƐĚĞĞůƐƚĞǀƌĞĚĞŶĞŶ ĞĞŶǁĂƐŶŝĞƚƚĞǀƌĞĚĞŶ͘ĞŐĞŵŝĚĚĞůĚĞƚĞǀƌĞĚĞŶŚĞŝĚƐƐĐŽƌĞ;s^ͿǁĂƐϳ͘ϱ;^ϭ͘ϲ͕ƌĂŶŐĞ ϲͲϭϬͿ͘ĂŶŐĞnjŝĞŶŽƵĚĞƌƐŵĂƟŐĞƚŽƚŐŽĞĚĞƚĞǀƌĞĚĞŶŚĞŝĚƌĂƉƉŽƌƚĞĞƌĚĞŶ͕ĐŽŶĐůƵĚĞƌĞŶ ǁĞĚĂƚ/dǁĂĂƌĚĞǀŽůŬĂŶnjŝũŶŝŶĚĞďĞŚĂŶĚĞůŝŶŐǀĂŶƉĂƟģŶƚĞŶŵĞƚWE͘
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ŝƐŚĞƚŝŶƚĞƌĞƐƐĂŶƚŽŵƚĞnjŝĞŶŽƉǁĞůŬĞŵĂŶŝĞƌŚĞƚĞīĞĐƚĂĂŶǁĞnjŝŐďůŝũŌŶĂĂƌŵĂƚĞĚĞ follow up langer is.
