European Journal of Pediatrics

, Volume 171, Issue 10, pp 1541–1547 | Cite as

Baclofen intoxication: a “fun drug” causing deep coma and nonconvulsive status epilepticus—a case report and review of the literature

  • Guido F. Weißhaar
  • Marc Hoemberg
  • Katja Bender
  • Ursula Bangen
  • Peter Herkenrath
  • Frank Eifinger
  • Markus Rothschild
  • Bernhard Roth
  • André Oberthuer
Original Paper
First Online:
Received:
Accepted:

Abstract

The number of reports on baclofen intoxication has increased in recent years. We report a 15-year-old boy who was referred in a state of deep coma (Glasgow Coma Scale = 3). On clinical examination, he showed sinus bradycardia with normal blood pressure. On admission to the hospital, he presented intermittent short episodes of generalized tonic–clonic seizures. While results of imaging procedures and initial toxicological screening (including standard HPLC analysis and urine test) were negative, a nonconvulsive status epilepticus was diagnosed by electroencephalography (EEG). Identification of baclofen as causative agent was possible after the boy’s father reported abusive baclofen intake. Subsequent toxicological target analysis of blood and urine samples confirmed the excessive intake of baclofen and showed a typical elimination pattern with a secondary release. Following 112 h of mechanical ventilation, the boy rapidly regained consciousness and recovered normal neurological behavior. Conclusions: The present case demonstrates the importance of considering baclofen overdosage in cases of severe coma in combination with an abnormal EEG pattern and sinus bradycardia with normal blood pressure levels, in particular as the substance is popular in internet reports promoting baclofen as a rather harmless “fun drug.” Furthermore, it underlines the difficulty to identify baclofen as a causative agent without anamnestic information. Nevertheless, by reviewing existing literature on oral baclofen overdosage, it is possible to picture a nearly specific pattern of clinical symptoms in baclofen intoxication.

Keywords

Coma Drug abuse Baclofen Nonconvulsive status epilepticus Sinus bradycardia 
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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Guido F. Weißhaar
    • 1
  • Marc Hoemberg
    • 1
  • Katja Bender
    • 2
  • Ursula Bangen
    • 1
  • Peter Herkenrath
    • 3
  • Frank Eifinger
    • 1
  • Markus Rothschild
    • 2
  • Bernhard Roth
    • 1
  • André Oberthuer
    • 1
  1. 1.Neonatal and Pediatric Intensive Care UnitUniversity Hospital of CologneCologneGermany
  2. 2.Institute of Legal Medicine, Medical FacultyUniversity of CologneCologneGermany
  3. 3.Department of NeuropediatricsUniversity Hospital of CologneCologneGermany

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