The test dose – are you a candidate?

One important benefit of ITB therapy is that you can try it first during a screening test before you commit to placement of a permanent pump for long-term therapy. This is an opportunity to see how your body will react to the medication, and your experience during the screening test will be used by you and your doctors to decide if long-term therapy is right for you.

The screening test is performed as an outpatient in the "day stay" unit at the hospital. Once you come to the hospital, and have been evaluated by the nurse and physical therapist, the doctor will perform a lumbar puncture (spinal tap) and inject a single small test dose of the medication directly into the spinal canal. The medication may take 30 to 60 mins to begin to relax your muscles, and has a peak effect at about 4 hours after the injection. During this time you will be carefully monitored, and undergo repeated examinations to look for a benefit in terms of reduced muscle tone, increased flexibility, and change in function (for example ability to transfer and walk).

The effect of a single dose of medication can last between 4 and 8 hours, and once the medication wears off you will return to the same degree of spasticity you had prior to the test.

It is important to note that everybody responds differently to the test dose - your muscles may loosen slightly, or your muscles may feel so completely looser week that you can't use them especially her legs.

During the screening test there may be temporary side effects including overly loose muscles (causing muscle weakness), headache, sleepiness, dizziness and low blood pressure, and/or nausea and vomiting may occur. However, be assured that the nursing and medical staff have experienced with identifying and dealing with these complications, and any side effects of the medication are only temporary.

If there was insufficient benefit from the test dose, your physician may suggest that you come back another day to try it again with a higher dose.

If the test dose improved your spasticity, but made your legs feel a little weaker, you still may be a candidate for ITB therapy because the medication can be delivered in a mpre controlled fashion via a programmable pump than by a single bolus injection.

After your screening test(s) have been completed, you will discuss your results with your physician, and determine if you might be a candidate for long term ITB therapy through an implanted pump.

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