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Long-term oral baclofen treatment in a child with cerebral palsy: electroencephalographic changes and clinical

Marta De Rinaldis1, Luciana Losito, Leonarda Gennaro

  • 1Neurorehabilitation Unit I, Developmental Neurology and Functional Rehabilitation, Scientific Institute IRCCS Eugenio Medea, La Nostra Famiglia, Ostuni, Italy.

Journal of Child Neurology
|February 9, 2010
PubMed

Insights

Baclofen, used for cerebral palsy spasticity, may worsen epilepsy. A child experienced adverse effects and EEG changes, suggesting baclofen can potentiate seizures.

Area of Science:

  • Neurology
  • Pediatrics
  • Pharmacology

Background:

  • Baclofen is a common treatment for spasticity in pediatric cerebral palsy.
  • The proconvulsant effects of baclofen remain debated despite its widespread use.

Observation:

  • A 10-year-old female with cerebral palsy, epilepsy, and intellectual disability experienced adverse effects during baclofen therapy.
  • Clinical symptoms included confusion, agitation, insomnia, hypotonia, and hyporeflexia.
  • Electroencephalographic (EEG) monitoring revealed generalized burst of sharp waves, indicative of seizure potentiation.

Findings:

  • The patient's EEG abnormalities emerged after a dosage increase of oral baclofen, within the therapeutic range.
  • These findings suggest a direct link between baclofen escalation and seizure activity in this patient.
  • The study explores potential mechanisms for baclofen's proconvulsant effect.

Implications:

  • This case highlights the potential risk of baclofen-induced seizure potentiation in epileptic children with cerebral palsy.
  • Clinicians should carefully monitor EEG and clinical status during baclofen treatment, especially with dosage adjustments.
  • Further research is warranted to elucidate the precise mechanisms and identify at-risk populations.

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