부산대학교 도서관

Cerebral palsy leads to severe growth disorder, as well as disturbance of intellectual and motor functions. Additionally, particularly in severe cases, muscle growth is inadequate during the growth period, and there is remarkable weight loss. In this study, we investigated changes in body weight in 12 patients with cerebral palsy who received intrathecal baclofen (ITB) therapy for abnormal muscle tone for more than 1 year via an implanted pump. The study outcome was the change in body weight during the course of treatment for 1 year. We also investigated the involvement of several factors in weight changes, degree of underweight, age, presence or absence of tracheostomy, etc. Ten cases were classified as Gross Motor Function Classification System (GMFCS) level V. Prior to pump implantation, most cases had undergone botulinum toxin type-A therapy. There were no significant differences in body weight changes in the periods 1 year before and after ITB. However, some pediatric cases showed weight gain 1 year after surgery. Even in adults, weight gain was observed in two out of five cases requiring hospitalization and management in a ward for severely mentally and physically disabled persons rather than living at home. Examination of the factors associated with weight gain showed that patients in whom the baseline value of the relevant score was less than two standard deviations (SD) below the reference standard and those receiving nutrition through a gastrostomy showed significant postoperative weight gain. After 2 years of ITB therapy, no increase in body weight was observed compared to 1 year after pump implantation. Severe cerebral palsy causes weight loss due to gastroesophageal reflux, vomiting, and eating disorders due to muscle tone abnormalities, along with the retention of gastric contents in the fundus of the stomach. In severely underweight and gastrostomy-fed patients, ITB therapy might trigger weight gain.