• J Spinal Cord Med · Jan 2006

    Case Reports

    Intrathecal baclofen toxicity and deep coma in minutes.

    • Yusuf Tunali, Hakan Hanimoglu, Taner Tanriverdi, Lale Hanci, and Murat Hanci.
    • Istanbul University, Cerrahpasa Medical Faculty, Department of Anesthesiology, Istanbul, Turkey.
    • J Spinal Cord Med. 2006 Jan 1;29(3):237-9.

    Background/ObjectiveIn 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.MethodsA 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.ResultsAfter proper management, the patient was followed and continued to receive ITB treatment.ConclusionsITB 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.

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