Twisted catheter causing baclofen pump malfunction: a case report.

a 49-year-old man presented with a history of multiple sclerosis, causing him increased tone and spasticity in the lower extremities. this severely affected his ambulation and mobility. Following the titration of oral baclofen and tizanidine to maximum tolerated doses with little impact on his spasticity, the patient agreed to a trial dose of 50 μg of intrathecal baclofen (itB), which was effective in reducing his spasticity and improving mobility. He subsequently underwent implantation of a SynchroMed ii (Medtronic, Minneapolis, Minn) itB pump, with the tip of the catheter placed at the t10/t11 junction, and the pump placed in the right upper quadrant of his abdomen. the patient’s spasticity and mobility improved on a small daily dose of itB, 500 micrograms per ml (91 μg/day). He lived at a distance from the center, and appeared to be doing well with the small dose, and therefore had not had any further adjustments. Six months postoperatively, he noticed return of the spasms. His Twisted Catheter Causing Baclofen Pump Malfunction: A Case Report