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Paralytic ileus: a complication after intrathecal baclofen therapy
Amparo Morant1, Enrique Noé, José Boyer
1Servicio de Daño Cerebral, Hospitales Nisa, Instituto Valenciano de Neurorrehabilitación, Valencia, Spain.
Brain Injury
|March 24, 2007
Summary
Intrathecal baclofen, used for spasticity, can rarely cause paralytic ileus. Reducing the baclofen dose is recommended, particularly in patients with brainstem injuries, to manage this side effect.
Area of Science:
- Neurology
- Pharmacology
Background:
- Intrathecal baclofen is a treatment for spasticity when oral administration is insufficient.
- This administration route allows for lower dosages and potentially fewer side effects compared to oral baclofen.
Observation:
- A 52-year-old male with tetraplegia post-brainstem stroke developed paralytic ileus after initiating intrathecal baclofen therapy via an infusion pump.
- The ileus resolved after conservative management and reducing the baclofen dosage to the lowest flow rate.
Findings:
- Paralytic ileus is identified as a rare potential side effect of intrathecal baclofen.
- Baclofen's direct action on brainstem nuclei may increase the risk of ileus in patients with brainstem injuries.
Implications:
- Clinicians should consider ileus as a possible complication of intrathecal baclofen, especially in patients with neurological deficits affecting the brainstem.
- Dose reduction of intrathecal baclofen should be a primary consideration for managing this adverse event.
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