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Intrathecal Baclofen Pump Refill-Related Cardiac Arrest: A Case Report.

Mohammad Aldalahmeh1, Elie Bou Sanayeh1, Waleed Sadiq2

  • 1Department of Internal Medicine, Staten Island University Hospital/Northwell Health, Staten Island, New York, USA.

Journal of Pain & Palliative Care Pharmacotherapy
|November 28, 2024
PubMed
Summary

Intrathecal baclofen poisoning can cause severe toxicity, including respiratory failure and cardiac arrest. Prompt recognition and intervention are crucial for managing this life-threatening condition in patients with multiple sclerosis.

Keywords:
Case reportbaclofen toxicitycardiac arrestintrathecal baclofen pump

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Area of Science:

  • Neurology
  • Pharmacology
  • Critical Care Medicine

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease causing spasticity and paraplegia.
  • Intrathecal baclofen pumps are used to manage severe spasticity in MS patients.
  • Complications of intrathecal baclofen therapy can include overdose and toxicity.

Purpose of the Study:

  • To report a case of severe intrathecal baclofen poisoning.
  • To highlight the critical importance of recognizing baclofen toxicity in patients with MS.
  • To emphasize the need for prompt management of intrathecal baclofen overdose.

Main Methods:

  • Case report of a 45-year-old male with MS.
  • Detailed description of the patient's presentation, including altered mental status and respiratory failure post-pump refill.
  • Documentation of the patient's cardiac arrests and subsequent management.

Main Results:

  • The patient developed life-threatening symptoms, including cardiac arrest, shortly after an intrathecal baclofen pump refill.
  • Aspiration of pump contents led to patient stabilization.
  • The case illustrates a severe adverse event related to intrathecal baclofen administration.

Conclusions:

  • Vigilance and rapid diagnosis of intrathecal baclofen poisoning are essential.
  • Prompt recognition and intervention can prevent fatal outcomes from baclofen toxicity.
  • This case underscores the potential for severe toxicity and withdrawal syndromes associated with intrathecal baclofen therapy.