Prolonged, Severe Intrathecal Baclofen Withdrawal Syndrome: A Case Report

Archives of Physical Medicine and Rehabilitation

Volumn 88, Issue 11, 2007, Pages 1468-1471

  Hansen, Colby R ^a   Gooch, Judith L ^a,b   Such Neibar, Teresa ^a,b  

^a UNIVERSITY OF UTAH HEALTH SCIENCES CENTER   (United States)

^b PRIMARY CHILDREN'S MEDICAL CENTER   (United States)

Author keywords

Baclofen; Case report; Cerebral palsy; Infusion pumps, implantable; Muscle spasticity; Rehabilitation; Substance withdrawal syndrome

Indexed keywords

4 AMINOBUTYRIC ACID B RECEPTOR; BACLOFEN; BENZODIAZEPINE DERIVATIVE; OPIATE DERIVATIVE;

AGITATION; ARTICLE; CASE REPORT; CATHETER; CEREBRAL PALSY; CHILD; DEVICE INFECTION; DEVICE REMOVAL; DRUG WITHDRAWAL; FEMALE; FUNCTIONAL STATUS; HOSPITAL; HUMAN; HYPERTENSION; INTENSIVE CARE; LITERATURE; MENINGITIS; PUMP; QUADRIPLEGIA; SEDATION; SPASTICITY; SYMPTOM; TACHYCARDIA;

ADOLESCENT; BACLOFEN; CEREBRAL PALSY; CHILD; CROSS INFECTION; DEVICE REMOVAL; DOSE-RESPONSE RELATIONSHIP, DRUG; DRUG ADMINISTRATION SCHEDULE; EQUIPMENT CONTAMINATION; EQUIPMENT FAILURE; HUMANS; INFUSION PUMPS, IMPLANTABLE; INJECTIONS, SPINAL; INTENSIVE CARE; MENINGITIS, BACTERIAL; MIDAZOLAM; MUSCLE RELAXANTS, CENTRAL; NEUROLOGIC EXAMINATION; PSEUDOMONAS INFECTIONS; QUADRIPLEGIA; SUBSTANCE WITHDRAWAL SYNDROME;

EID: 35448941165     PISSN: 00039993     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.apmr.2007.07.021     Document Type: Article

References (24)

1. Albright A.L., Gilmartin R., Swift D., Krach L.E., Ivanhoe C.B., and McLaughlin J.F. Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin. J Neurosurg 98 (2003) 291-295
2. Coffey R.J., Cahill D., Steers W., et al. Intrathecal baclofen for intractable spasticity of spinal origin: results of a long-term multicenter study. J Neurosurg 78 (1993) 226-232
3. Albright A.L., Barron W.B., Fasick M.P., Polinko P., and Janosky J. Continuous intrathecal baclofen infusion for spasticity of cerebral origin. JAMA 270 (1993) 2475-2477
4. Gerszten P.C., Albright A.L., and Barry M.J. Effect on ambulation of continuous intrathecal baclofen infusion. Pediatr Neurosurg 27 (1997) 40-44
5. Gooch J.L., Oberg W.A., Grams B., Ward L.A., and Walker M.L. Care provider assessment of intrathecal baclofen in children. Dev Med Child Neurol 46 (2004) 548-552
6. Gooch J.L., Oberg W.A., Grams B., Ward L.A., and Walker M.L. Complications of intrathecal baclofen pumps in children. Pediatr Neurosurg 39 (2003) 1-6
7. Alden T.D., Lytle R.A., Park T.S., Noetzel M.J., and Ojemann J.G. Intrathecal baclofen withdrawal: a case report and review of the literature. Childs Nerv Syst 18 (2002) 522-525
8. Coffey R.J., Edgar T.S., Francisco G.E., et al. Abrupt withdrawal from intrathecal baclofen: recognition and management of a potentially life-threatening syndrome. Arch Phys Med Rehabil 83 (2002) 735-741
9. Douglas A.F., Weiner H.L., and Schwartz D.R. Prolonged intrathecal baclofen withdrawal syndrome. Case report and discussion of current therapeutic management. J Neurosurg 102 (2005) 1133-1136
10. Bloom F.E. Neurotransmission and the central nervous system. In: Brunton L.L., Lazo J.S., and Parker K.L. (Eds). Goodman & Gilman's the pharmacological basis of therapeutics. 11th ed. (2006), McGraw-Hill, New York 330
11. Bennaroch E.E., Daube J.R., Sandok B.A., Reagan T.J., and Westmoreland B.F. Medical neurosciences: an approach to anatomy, pathology, and physiology by systems and levels. 4th ed. (1999), Lippincott Williams & Wilkins, Philadelphia p 376, 406
12. Kroin J.S., Bianchi G.D., and Penn R.D. Intrathecal baclofen down-regulates GABAB receptors in the rat substantia gelatinosa. J Neurosurg 79 (1993) 544-549
13. Meythaler J.M., Roper J.F., and Brunner R.C. Cyproheptadine for intrathecal baclofen withdrawal. Arch Phys Med Rehabil 84 (2003) 638-642
14. Khorasani A., and Peruzzi W.T. Dantrolene treatment for abrupt intrathecal baclofen withdrawal. Anesth Analg 80 (1995) 1054-1056
15. Addolorato G., Leggio L., Agabio R., Colombo G., and Gasbarrini G. Baclofen: a new drug for the treatment of alcohol dependence. Int J Clin Pract 60 (2006) 1003-1008
16. Addolorato G., Leggio L., Abenavoli L., et al. Baclofen in the treatment of alcohol withdrawal syndrome: a comparative study vs diazepam. Am J Med 119 (2006) 276 e13-8
17. Sofuoglu M., and Kosten T.R. Novel approaches to the treatment of cocaine addiction. CNS Drugs 19 (2005) 13-25
18. Assadi S.M., Radgoodarzi R., and Ahmadi-Abhari S.A. Baclofen for maintenance treatment of opioid dependence: a randomized double-blind placebo-controlled clinical trial [ISRCTN32121581]. BMC Psychiatry 3 (2003) 16
19. Akhondzadeh S., Ahmadi-Abhari S.A., Assadi S.M., Shabestari O.L., Kashani A.R., and Farzanehgan Z.M. Double-blind randomized controlled trial of baclofen vs. clonidine in the treatment of opiates withdrawal. J Clin Pharm Ther 25 (2000) 347-353
20. Leite-Morris K.A., Fukudome E.Y., Shoeb M.H., and Kaplan G.B. GABA(B) receptor activation in the ventral tegmental area inhibits the acquisition and expression of opiate-induced motor sensitization. J Pharmacol Exp Ther 308 (2004) 667-678
21. Ford C.P., Mark G.P., and Williams J.T. Properties and opioid inhibition of mesolimbic dopamine neurons vary according to target location. J Neurosci 26 (2006) 2788-2797
22. Suzuki T., Nurrochmad A., Ozaki M., et al. Effect of a selective GABA(B) receptor agonist baclofen on the mu-opioid receptor agonist-induced antinociceptive, emetic and rewarding effects. Neuropharmacology 49 (2005) 1121-1131
23. Kroin J.S. Intrathecal drug administration, present use and future trends. Clin Pharmacokinet 22 (1992) 319-326
24. Soni B.M., Mani R.M., and Oo T. Treatment of spasticity in a spinal cord-injured patient with intrathecal morphine due to intrathecal baclofen tolerance-a case report and review of the literature. Spinal Cord 41 (2003) 586-589