Long-term oral baclofen treatment in a child with cerebral palsy: electroencephalographic changes and clinical adverse effects.
Baclofen is widely used to control spasticity in children with cerebral palsy. Several publications described clinical adverse effects of baclofen oral treatment, but the effect of baclofen on seizure potentiation is still controversial. We describe a 10-year-old female patient with cerebral palsy, epilepsy, and mental retardation who developed clinical adverse effects (confusion, agitated state, insomnia, diffuse hypotonia, and hyporeflexia) and electroencephalographic (EEG) changes (quasiperiodic, generalized burst of sharp waves that take up >50% of standard EEG) during long-term oral baclofen treatment, after gradually increasing the dosage but still within the therapeutic dose. Our case showed clearly that the EEG changes in our patient, with a history of epilepsy in good control, have been induced by the baclofen increase, and we describe the possible mechanisms that could explain proconvulsive effect of baclofen.
Neurorehabilitation Unit I, Developmental Neurology and Functional Rehabilitation, Scientific Institute IRCCS Eugenio Medea, La Nostra Famiglia, Ostuni, Italy.
Marta
M
De Rinaldis
Luciana
L
Losito
Leonarda
L
Gennaro
Antonio
A
Trabacca
D001418:Baclofen / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology; D058256:Brain Waves / Q000187:drug effects / Q000502:physiology; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D004569:Electroencephalography / Q000187:drug effects*; D004827:Epilepsy / Q000139:chemically induced / Q000209:etiology; D005260:Female; D058786:GABA-B Receptor Agonists / Q000009:adverse effects; D006801:Humans; D013997:Time Factors
D058786:GABA-B Receptor Agonists; D001418:Baclofen