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Prolonged, severe intrathecal baclofen withdrawal syndrome: a case report


, : Prolonged, severe intrathecal baclofen withdrawal syndrome: a case report. Archives of Physical Medicine and Rehabilitation 88(11): 1468-1471

Intrathecal baclofen (ITB) withdrawal is a well-recognized complication when drug delivery is disrupted for any reason. ITB withdrawal varies widely in its severity and poses the very real possibility of death if not promptly managed. Cases of withdrawal lasting greater than 1 or 2 weeks, however, are sparse. We report the case of an 11-year-old girl with spastic quadriplegic cerebral palsy who developed an infected pump and subsequent meningitis, prompting the removal of her pump and catheter. She subsequently developed a severe, prolonged baclofen withdrawal syndrome marked by increased spasticity, agitation, hypertension, and tachycardia that lasted nearly 2 months, requiring intensive care and continuous intravenous sedation with benzodiazepines and opiates. Her pump was eventually replaced on hospital day 56 and within 24 hours her symptoms dramatically improved. She was eventually weaned off sedating medications and returned to baseline functional status. Typical management of baclofen withdrawal is reviewed. To date, the literature has not discussed the potential role for opiates in managing baclofen withdrawal, yet a growing body of literature is examining the interplay between opiates and gamma-aminobutyric acid B pathways. A potential role for opiates in managing severe baclofen withdrawal is proposed.

US$19.90

PMID: 17964889

DOI: 10.1016/j.apmr.2007.07.021


Other references

Lundell, I.; Ringvall, M.; Starback, P.; Salaneck, E.; Berglund, M.; Larhammar, D., 1998: Cloning of neuropeptide Y receptors in zebrafish. Vaudry, H [Editor], Tonon, M -C [Editor], Roubos, E W [Editor], de Loof, A [Editor] Annals of the New York Academy of Sciences; Trends in comparative endocrinology and neurobiology: From molecular to integrative biology 515-517

Ramos, N.L.; Sekikubo, M.; Dzung, D.Thi.Ngoc.; Kosnopfel, C.; Kironde, F.; Mirembe, F.; Brauner, A., 2013: Uropathogenic Escherichia coli isolates from pregnant women in different countries. Urinary tract infection (UTI) is common during pregnancy and can be associated with negative outcomes for both the mother and fetus. Increased risk of infection among these patients has been attributed to physiological changes, and less focus has...

Weissenstein, E., 1993: Medicare changes off budget, in doubt. Modern Healthcare 23(33): 33-33

M.L.iva-Brondo; M.V.lcárcel; C.C.rtés-Olmos; S.R.selló; J.C.bolla-Cornejo; F.N.ez, 2012: Exploring alternative germplasm for the development of stable high vitamin C content in tomato varieties. The genotypic potential for highl-ascorbic acid content of 15 accessions ofS. lycopersiconandS. pimpinellifoliumhas been evaluated in three environments, including open-air and glasshouse cultivation and two localities. The environmental effect on...

Hsu, Y-Hsiang.; Li, H-Hui.; Hsieh, M-Yi.; Liu, M-Fei.; Huang, K-Yuan.; Chin, L-Show.; Chen, P-Chih.; Cheng, H-Hsiung.; Chang, M-Shi., 2006: Function of interleukin-20 as a proinflammatory molecule in rheumatoid and experimental arthritis. Objective. The pathogenesis of rheumatoid arthritis (RA) reflects an ongoing imbalance between proinflammatory and antiinflammatory cytokines. Interleukin-20 (IL-20) has proinflammatory properties for keratinocytes. In this study, we sought to de...

Cartwright, S.J.; Fink, A.L., 1982: Isolation of a covalent intermediate in beta -lactamase I catalysis. Febs Letters 137(2): 186-188

Hoffman, J., 1998: Music therapy and home care. As home care looks to alternative programs to serve the community and generate income, one service that is beginning to attract more attention is music therapy. As a means to relaxation and healing, this therapy can help patients heal from within...

Maija Pesonen; Lars Förlin; Tiiu Hansson; Tommy Andersson, 1988: Xenobiotic and steroid metabolism in juvenile rainbow trout kidney. Marine Environmental Research 24(1-4): 116-117

Kay, C., 1980: The agrarian reform in Peru: an assessment. Reference is made in the historical background (there is also a geographical background summary) to two major conflicts between landlords and peasants in the Highlands of Peru. Agrarian reform rather than resolving these conflicts gave them a diff...

Bergot, E.; Haustraete, E.; Malbruny, B.; Magnier, R.; Salaün, M-Anne.; Zalcman, Gérard., 2013: Observational study of QuantiFERON®-TB gold in-tube assay in tuberculosis contacts in a low incidence area. QuantiFERON®-TB Gold in-Tube (QFT) assay is a recently developed test to assess latent tuberculosis infection in contagious tuberculosis (TB) contact subjects. To assess the QFT assay in recently exposed contacts of active tuberculosis patients i...