2009 Faculty Researchers

Reza Farid, MD

Open Label Treatment of Severe Tactile Defensiveness with Intrathecal Baclofen.

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Department

Physical Medicine and Rehabilitation

Office Location

315 Business Loop 70 West

Phone #:

Office: (573) 882-3101
Fax: (573) 884-4540

Summary

Observations from a recent case study indicate that intrathecal baclofen may have efficacy for treatment of severe tactile defensiveness and symptoms of autism spectrum disorder (ASD). A patient with tactile defensiveness and ASD had a subsequent traumatic brain injury (TBI). The TBI resulted in spasticity that was refractory to several treatments. The patient underwent an intrathecal baclofen trial for treatment of spasticity. Intrathecal baclofen reduced spasticity as desired. Unexpectedly, the patient’s tactile defensiveness and symptoms of ASD also were reduced during the trial. Since the trial procedure indicated efficacy of intrathecal baclofen for spasticity treatment, an intrathecal pump system to deliver baclofen was surgically implanted. Prior to pump implantation, the patient’s progress was severely limited and his level of dependent care was high. After pump implantation, he demonstrated rapid and marked improvement. Self care tasks that previously required the assistance of two helpers could be done by the patient independently or with minimal assistance. The area of most marked improvement was in the patient’s ability to interact with his environment. The degree to which he became tolerable of external stimulation was excellent. His social interaction skills, language, mobility, and ability for self-care were greatly improved. We are proposing an open label pilot study with five patients who have severe tactile defensiveness and ASD to evaluate whether intrathecal baclofen will reduce tactile defensiveness and ASD symptoms in these patients. Each patient will undergo the intrathecal baclofen trial procedure, and changes in tactile defensiveness and ASD symptoms after treatment will be evaluated.