title: Baclofen withdrawal following removal of an intrathecal baclofen pump despite oral baclofen replacement.
abstract: Intrathecal baclofen is used as a muscle relaxant and antispasmodic in cases of spasticity resulting from central nervous system trauma. The baclofen withdrawal syndrome may include hyperthermia, tachycardia, hypertension, seizures, altered mental status, and psychomotor agitation. We report a case in which the removal of a baclofen pump lead tothe development of severe withdrawal symptoms despite oral baclofen replacement therapy. In order to avoid the development of withdrawal, adequate doses of GABA agonist agents should be administered immediately prior to, and following, baclofen pump removal.
authors.affiliation: Department of Emergency Medicine, Division of Toxicology, Drexel University College of Medicine, Philadelphia, Pennsylvania 19129, USA mg43@drexel.edu
authors.forename: Michael I
authors.initials: MI
authors.lastname: Greenberg
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hendrickson
mesh_terms: D000328:Adult; D001418:Baclofen / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D018755:GABA Agonists / Q000627:therapeutic use; D058785:GABA-A Receptor Agonists; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology; D011782:Quadriplegia / Q000150:complications; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology* / Q000628:therapy
chemical_list: D018755:GABA Agonists; D058785:GABA-A Receptor Agonists; D009125:Muscle Relaxants, Central; D001418:Baclofen