Neuroleptic malignant-like syndrome after abrupt withdrawal of baclofen.
We present the case of a 36-year-old man who presented with a clinically neuroleptic malignant-like syndrome involving disorientation, signs of autonomic dysfunction, rigidity and raised total creatine kinase level, but in the absence of any neuroleptic medication. He had, however, abruptly stopped taking his long-term baclofen in the days prior to presentation. He improved markedly after the reintroduction of baclofen, and we postulate that his clinical syndrome resulted from the sudden withdrawal of this drug. We concur with the concept that neuroleptic malignant syndrome represents a spectrum of disorders, and add it to the list of possible sequelae after abrupt withdrawal of baclofen.
Academic Neurosciences Centre, Institute of Psychiatry, London, UK. m.turner@iop.kcl.ac.uk
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Turner
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Gainsborough
D000328:Adult; D001418:Baclofen / Q000009:adverse effects* / Q000627:therapeutic use; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography / Q000187:drug effects; D006801:Humans; D008297:Male; D009125:Muscle Relaxants, Central / Q000009:adverse effects* / Q000627:therapeutic use; D009127:Muscle Rigidity / Q000139:chemically induced; D009459:Neuroleptic Malignant Syndrome / Q000523:psychology*; D010264:Paraplegia / Q000150:complications; D013375:Substance Withdrawal Syndrome / Q000523:psychology*
D009125:Muscle Relaxants, Central; D003402:Creatine Kinase; D001418:Baclofen