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Acute Intrathecal Baclofen Withdrawal: A Brief Review of Treatment Options

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Abstract

Background

Acute baclofen toxicity and withdrawal can present with a constellation of symptoms making differentiation between these two entities and other potential diagnoses challenging. Baclofen withdrawal is associated with numerous complications which may require neurocritical care expertise such as respiratory failure, refractory seizures, delirium, and blood pressure lability.

Methods

Case report and literature review.

Results

This case report discusses a case of intrathecal baclofen (ITB) withdrawal, focusing on the differential diagnosis for acute baclofen withdrawal and reviews the various options that exist to treat the symptoms of acute baclofen withdrawal such as benzodiazepines, propofol, skeletal muscle relaxants, and tizanidine.

Conclusions

Critical care practitioners should be prepared to treat this potentially devastating and often refractory complication of ITB therapy.

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Authors and Affiliations

  1. Department of Pharmacy, Saint Joseph Health System, 1 Saint Joseph Dr, Lexington, KY, 40504, USA

    James C. Ross

  2. Pharmacy Services, UKHealthcare, 800 Rose St. H109a, Lexington, KY, 40536, USA

    Aaron M. Cook

  3. Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, 800 Rose St. H109a, Lexington, KY, 40536, USA

    Aaron M. Cook

  4. Department of Anesthesiology, UKHealthcare, 800 Rose St. H109a, Lexington, KY, 40536, USA

    Gary L. Stewart & Brenda G. Fahy

  5. Department of Neurosurgery, UKHealthcare, 800 Rose St. H109a, Lexington, KY, 40536, USA

    Brenda G. Fahy

Authors
  1. James C. Ross
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  2. Aaron M. Cook
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  3. Gary L. Stewart
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  4. Brenda G. Fahy
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Corresponding author

Correspondence to Aaron M. Cook.

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Ross, J.C., Cook, A.M., Stewart, G.L. et al. Acute Intrathecal Baclofen Withdrawal: A Brief Review of Treatment Options. Neurocrit Care 14, 103–108 (2011). https://doi.org/10.1007/s12028-010-9422-6

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  • DOI: https://doi.org/10.1007/s12028-010-9422-6

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