Management Baclofen Withdrawal Syndrome
Keywords:
Baclofen, Substance withdrawal syndrome, Spinal injections, Muscle spasticity
Abstract
Intrathecal baclofen therapy is a treatment that can relieve some symptoms of severe spasticity. Currently intrathecal baclofen infusion is used primarily for spasticity associated with cerebral palsy, brain or spinal injury, traumatic brain injury, anoxic encephalopathy, multiple sclerosis, dystonia, stroke and stiff-man syndrome, particularly for those patients who are unresponsive. Patients can present central nervous system side effects, this can occur as a result of the pump delivering an incorrect dose of baclofen. Sudden cessation of Intrathecal baclofen administration can cause mild to severe symptoms. We report a case of Intrathecal baclofen withdrawal syndrome developing severe spasticity and its management.
References
1. Coffey RJ, Edgar TS, Francisco GE, Graziani V, Meythaler JM, Ridgely PM, et al. Abrupt withdrawal from intrathecal baclofeno: recognition and management of a potentially lifethreatening syndrome. Arch Phys Med Rehabil. 2002;83:735-41.
2. Kolaski K, Logan LR. A review of the complications of intrathecal baclofen in patients with cerebral palsy. Neuro Rehabil. 2007;22:383-95.
3. Brennan PM, Whittle IR. Intrathecal baclofeno therapy for neurological disorders: a sound knowledge base but many challenges remain. Br J Neurosurg. 2008;22:508-19.
4. Dykstra D, Stuckey M, DesLauriers L, Chappuis D, Krach L. Intrathecal baclofeno in the treatment of spasticity. Acta Neurochir Suppl. 2007;97(Pt 1):163-71.
5. Stempien L, Tsai T. Intrathecal baclofeno pump use for spasticity: a clinical survey. Am J Phys Med Rehabil. 2000;79:536-41.
6. Gilmartin R, Bruce D, Storrs BB, Abbott R, Krach L, Ward J, et al. Intrathecal baclofeno for management of spastic cerebral palsy: multicenter trial. J Child Neurol. 2000;15:71-7.
7. Coffey RJ, Edgar TS, Franciso GE, et al. Abrupt withdrawal from intrathecal baclofeno: recognition and management of a potentially life-threatening syndrome. Arch Phys Med Rehabil. 2002;83:735-40.
8. Kao LW, Amin Y, Kirk MA, et al. Intrathecal baclofeno withdrawal mimicking sepsis. J Emerg Med. 2003;24:423-7.
9. Coffey RJ, Edgar TS, Francisco GE, et al. Abrupt withdrawal from intrathecal baclofeno: recognition and management of potentially lifethreatening syndrome. Arch Phys Med Rehabil. 2002;83:735-41.
10. U.S. Food and Drug Administration. MedWatch. The FDA Safety Information and Adverse Event Reporting Program. Lioresal Intrathecal (baclofeno injection) cited April 2002, Available from: http://www.fda.gov/Safety/MedWatch/Safetylnformation/SafetyAlertsforHumanMedicalProducts/ucm154505.htm
11. Duhon BS, MacDonald JD. Infusion of intrathecal baclofeno for acute withdrawal. J Neurosurg. 2007;107:878-80.
12. Ackland GL, Fox R. Low-dose propofol infusion for controlling acute hyperspasticity after withdrawal of intrathecal baclofeno therapy. Anesthesiology. 2005;103: 663-5.
13. Khorasani A, Peruzzi WT. Dantroleno treatment for abrupt intrathecal baclofeno withdrawal. Anesth Analg. 1995;80:1054-6.
14. Schwieler L, Delbro DS, Engberg G, Ernardt S. The anesthetic agent propofol interacts with GABA(B)-receptors: an electrophysiological study in rat. Life Sci. 2003;72:2793-801.
15. Nadeson R, Goodchild CS. Antinociceptive properties of propofol: involvement of spinal cord F-aminobutyric acidA receptors. J Pharmacol Exp Ther. 1997;282:1181-6.
16. Bellinger A, Siriwetchadarak R, Rosenquist R, Greenlee J. Prevention of intrathecal baclofeno withdrawal syndrome successful use of a temporary intrathecal catheter. Reg Anesth Pain Med. 2009;34:600-2.
17. Ross JC, Cook AM, Stewart GL, Fahy BG. Acute intrathecal baclofeno withdrawal: a brief review of treatment options. Neurocritical Care. 2011;14:103-8.
2. Kolaski K, Logan LR. A review of the complications of intrathecal baclofen in patients with cerebral palsy. Neuro Rehabil. 2007;22:383-95.
3. Brennan PM, Whittle IR. Intrathecal baclofeno therapy for neurological disorders: a sound knowledge base but many challenges remain. Br J Neurosurg. 2008;22:508-19.
4. Dykstra D, Stuckey M, DesLauriers L, Chappuis D, Krach L. Intrathecal baclofeno in the treatment of spasticity. Acta Neurochir Suppl. 2007;97(Pt 1):163-71.
5. Stempien L, Tsai T. Intrathecal baclofeno pump use for spasticity: a clinical survey. Am J Phys Med Rehabil. 2000;79:536-41.
6. Gilmartin R, Bruce D, Storrs BB, Abbott R, Krach L, Ward J, et al. Intrathecal baclofeno for management of spastic cerebral palsy: multicenter trial. J Child Neurol. 2000;15:71-7.
7. Coffey RJ, Edgar TS, Franciso GE, et al. Abrupt withdrawal from intrathecal baclofeno: recognition and management of a potentially life-threatening syndrome. Arch Phys Med Rehabil. 2002;83:735-40.
8. Kao LW, Amin Y, Kirk MA, et al. Intrathecal baclofeno withdrawal mimicking sepsis. J Emerg Med. 2003;24:423-7.
9. Coffey RJ, Edgar TS, Francisco GE, et al. Abrupt withdrawal from intrathecal baclofeno: recognition and management of potentially lifethreatening syndrome. Arch Phys Med Rehabil. 2002;83:735-41.
10. U.S. Food and Drug Administration. MedWatch. The FDA Safety Information and Adverse Event Reporting Program. Lioresal Intrathecal (baclofeno injection) cited April 2002, Available from: http://www.fda.gov/Safety/MedWatch/Safetylnformation/SafetyAlertsforHumanMedicalProducts/ucm154505.htm
11. Duhon BS, MacDonald JD. Infusion of intrathecal baclofeno for acute withdrawal. J Neurosurg. 2007;107:878-80.
12. Ackland GL, Fox R. Low-dose propofol infusion for controlling acute hyperspasticity after withdrawal of intrathecal baclofeno therapy. Anesthesiology. 2005;103: 663-5.
13. Khorasani A, Peruzzi WT. Dantroleno treatment for abrupt intrathecal baclofeno withdrawal. Anesth Analg. 1995;80:1054-6.
14. Schwieler L, Delbro DS, Engberg G, Ernardt S. The anesthetic agent propofol interacts with GABA(B)-receptors: an electrophysiological study in rat. Life Sci. 2003;72:2793-801.
15. Nadeson R, Goodchild CS. Antinociceptive properties of propofol: involvement of spinal cord F-aminobutyric acidA receptors. J Pharmacol Exp Ther. 1997;282:1181-6.
16. Bellinger A, Siriwetchadarak R, Rosenquist R, Greenlee J. Prevention of intrathecal baclofeno withdrawal syndrome successful use of a temporary intrathecal catheter. Reg Anesth Pain Med. 2009;34:600-2.
17. Ross JC, Cook AM, Stewart GL, Fahy BG. Acute intrathecal baclofeno withdrawal: a brief review of treatment options. Neurocritical Care. 2011;14:103-8.
How to Cite
1.
Santana L, Quintero M. Management Baclofen Withdrawal Syndrome. Colomb. J. Anesthesiol. [Internet]. 2012 Apr. 1 [cited 2024 May 5];40(2):158-61. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/830
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Published
2012-04-01
How to Cite
1.
Santana L, Quintero M. Management Baclofen Withdrawal Syndrome. Colomb. J. Anesthesiol. [Internet]. 2012 Apr. 1 [cited 2024 May 5];40(2):158-61. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/830
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Case Report / Case Series
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