A 66-year-old woman with Parkinson disease and multiple sclerosis had developed progressively worsening spasticity that had left her wheelchair-bound for the past 5 years.
For her spasticity, she had undergone placement of an intrathecal baclofen pump, which improved her spasticity but was followed by episodes of somnolence lasting 6 to 12 hours. These episodes became progressively more frequent, and now occur almost weekly.