Intrathecal baclofen toxicity and deep coma in minutes.
OBJECTIVE
In recent years, intrathecal baclofen (ITB) treatment in patients with refractory spasticity has been accepted as an effective therapy. However, this treatment modality may cause life-threatening complications. This report describes the clinical presentation, unfamiliar dilemmas, and treatment of a patient with ITB toxicity and raises awareness of problems that may arise.


METHODS
A 33-year-old man with refractory spasticity due to diffuse white matter injury was admitted for ITB treatment. The patient had respiratory difficulty followed by a generalized seizure and developed coma minutes after the drug administration. The patient was transferred into an intensive care unit immediately and managed accordingly.


RESULTS
After proper management, the patient was followed and continued to receive ITB treatment.


CONCLUSIONS
ITB therapy is a very effective method of rehabilitation and medication in patients with refractory spasticity, but physicians must be aware of the serious complications that may develop just minutes after the drug is administered. Although safe, baclofen pumps are nevertheless mechanical devices that may malfunction. Therefore, physicians should be mindful of the possibility of life-threatening complications that may develop and lead to a patient's death if proper treatment is not performed.
Tunali
Yusuf
Y
Istanbul University, Cerrahpasa Medical Faculty, Department of Anesthesiology, Istanbul, Turkey.
Hanimoglu
Hakan
H
Tanriverdi
Taner
T
Hanci
Lale
L
Hanci
Murat
M
D000328:Adult; D001418:Baclofen / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003128:Coma / Q000139:chemically induced*; 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
D009125:Muscle Relaxants, Central; D001418:Baclofen