Intrathecal Baclofen Toxicity and Deep Coma in Minutes

Background/Objective: In recent years, intrathecal baclofen (ITB) treatment in patients with refractory spasticity has been accepted as an effective therapy. However, this treatment modality may cause life- threatening complications. This report describes the clinical presentation, unfamiliar dilemm...

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Bibliographic Details
Published in:The journal of spinal cord medicine 2006-01, Vol.29 (3), p.237-239
Main Authors: Tunali, Yusuf, Hanimoglu, Hakan, Tanriverdi, Taner, Hanci, Lale, Hanci, Murat
Format: Article
Language:English
Subjects:
Adult
Baclofen
Baclofen - administration & dosage
Baclofen - adverse effects
Baclofen - therapeutic use
Case Report
Coma
Coma - chemically induced
Drug pump
Humans
Injections, Spinal
intrathecal
Male
Muscle Relaxants, Central - administration & dosage
Muscle Relaxants, Central - adverse effects
Muscle Relaxants, Central - therapeutic use
Muscle Spasticity - drug therapy
Seizure
Spasticity
Spinal cord injuries
toxicity
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Summary:Background/Objective: In recent years, intrathecal baclofen (ITB) treatment in patients with refractory spasticity has been accepted as an effective therapy. However, this treatment modality may cause life- threatening complications. This report describes the clinical presentation, unfamiliar dilemmas, and treatment of a patient with ITB toxicity and raises awareness of problems that may arise. Methods: A 33-year-old man with refractory spasticity due to diffuse white matter injury was admitted for ITB treatment. The patient had respiratory difficulty followed by a generalized seizure and developed coma minutes after the drug administration. The patient was transferred into an intensive care unit immediately and managed accordingly. Results: After proper management, the patient was followed and continued to receive ITB treatment. Conclusions: ITB therapy is a very effective method of rehabilitation and medication in patients with refractory spasticity, but physicians must be aware of the serious complications that may develop just minutes after the drug is administered. Although safe, baclofen pumps are nevertheless mechanical devices that may malfunction. Therefore, physicians should be mindful of the possibility of life-threatening complications that may develop and lead to a patient's death if proper treatment is not performed.
ISSN:1079-0268
2045-7723
DOI:10.1080/10790268.2006.11753880