[Severe hyperthermia caused by sudden withdrawal of continuous intrathecal administration of baclofen].
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.
Grenier
B
B
Département d'anesthésie-réanimation 3, hôpital Pellegrin, Bordeaux, France.
Mesli
A
A
Cales
J
J
Castel
J P
JP
Maurette
P
P
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
D009125:Muscle Relaxants, Central; D001418:Baclofen