Intrathecal baclofen withdrawal mimicking sepsis |
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Authors: | Kao Louise W Amin Yama Kirk Mark A Turner Michael S |
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Institution: | * Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA † Department of Medical Toxicology, Indiana University School of Medicine, Indianapolis, Indiana, USA ‡ Indianapolis Neurosurgical Group, Indianapolis, Indiana, USA |
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Abstract: | Baclofen (Lioresal™) is a drug of choice to treat spasticity and is increasingly being administered intrathecally via an implantable pump in cases refractory to oral therapy. Emergency physicians will likely treat patients with baclofen withdrawal or overdose as this treatment becomes more widespread. The syndrome of baclofen withdrawal presents with altered mental status, fever, tachycardia, hypertension or hypotension, seizures, and rebound spasticity, and may be fatal if not treated appropriately. Baclofen withdrawal may mimic other diseases including sepsis, meningitis, autonomic dysreflexia, malignant hyperthermia, or neuroleptic malignant syndrome. Treatment consists of supportive care, reinstitution of baclofen, benzodiazepines, and diagnosis and eventual repair of intrathecal pump and catheter malfunction. |
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Keywords: | baclofen withdrawal syndromes hyperpyrexia intrathecal pump device toxicology |
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