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Epileptic seizures associated with intrathecal baclofen application
M Kofler1, M F Kronenberg, C Rifici
1Department of Neurology, University of Innsbruck, Austria.
Neurology
|January 1, 1994
Summary
Intrathecal baclofen can cause seizures in patients with brain injuries. Antiepileptic drugs help manage these seizures, allowing continued treatment for spasticity.
Area of Science:
- Neurology
- Clinical Neurophysiology
Background:
- Intrathecal baclofen is used to manage spasticity.
- Traumatic brain injury (TBI) and spinal cord injury (SCI) are common conditions requiring spasticity management.
Observation:
- Three patients with a history of TBI (one with SCI) developed seizures after intrathecal baclofen administration.
- Seizures occurred after baclofen test bolus or dose adjustments, and in one case, after sleep deprivation.
Findings:
- Seizures associated with intrathecal baclofen appear linked to underlying structural brain disease.
- Patients with spasticity of solely spinal origin did not experience seizures with baclofen.
- EEG findings correlated with clinical seizure presentation.
Implications:
- Structural brain disease may be a prerequisite for baclofen-induced epileptogenicity.
- Careful patient selection and monitoring are crucial for intrathecal baclofen therapy.
- Antiepileptic medication can enable the continuation of intrathecal baclofen in affected patients.