title: [Severe hyperthermia caused by sudden withdrawal of continuous intrathecal administration of baclofen].
abstract: Baclofen is used for the treatment of post-traumatic spasticity. It carries a risk of overdose as well as of an acute withdrawal syndrome. We report two cases of severe hypertonia and hyperthermia (> 42 degrees C), occurring after accidental discontinuation of intrathecal infusion of baclofen. Both hypertonia and hyperthermia ceased when administration of baclofen was resumed. In parallel, the patients developed transient life-threatening alterations of hepatic (cytolysis), haematologic (coagulopathy) and cardiorespiratory functions for some days. It is concluded that the occurrence of such a withdrawal syndrome should be prevented, especially in patients with chronic intrathecal administration and first symptoms should be recognized without delay. Relationships with other malignant hyperthermias are discussed.
authors.affiliation: Département d'anesthésie-réanimation 3, hôpital Pellegrin, Bordeaux, France.
authors.forename: B
authors.initials: B
authors.lastname: Grenier
authors.forename: A
authors.initials: A
authors.lastname: Mesli
authors.forename: J
authors.initials: J
authors.lastname: Cales
authors.forename: J P
authors.initials: JP
authors.lastname: Castel
authors.forename: P
authors.initials: P
authors.lastname: Maurette
mesh_terms: D000328:Adult; D001418:Baclofen / Q000008:administration & dosage / Q000009:adverse effects*; D005334:Fever / Q000139:chemically induced*; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D009123:Muscle Hypotonia / Q000139:chemically induced; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000009:adverse effects*; D013375:Substance Withdrawal Syndrome
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen