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Hyperthermia associated with baclofen withdrawal and increased spasticity
B R Mandac1, E A Hurvitz, V S Nelson
1Department of Physical Medicine and Rehabilitation, University of Michigan Medical Center, Ann Arbor 48109.
Archives of Physical Medicine and Rehabilitation
|January 1, 1993
Summary
Rapid baclofen withdrawal can cause severe spasticity and, rarely, high fever. This case highlights a potential link between acute spasticity and hyperthermia in patients with spinal cord injury.
Area of Science:
- Neurology
- Pharmacology
Background:
- Baclofen is a muscle relaxant commonly used to manage spasticity.
- Rapid withdrawal of baclofen can lead to increased spasticity.
Observation:
- A 13-year-old boy with C1 quadriplegia experienced severe spasticity and hyperthermia (107°F) after baclofen tapering.
- Medical work-up, including sepsis evaluation, head CT, and EEG, was negative for other causes.
Findings:
- The patient's hyperthermia and spasticity resolved with cooling measures, intravenous diazepam, and baclofen dose increase.
- This suggests a possible hypermetabolic state secondary to acute spasticity as the cause of fever.
Implications:
- This case suggests fever may be an underreported complication of rapid baclofen withdrawal.
- Clinicians should consider baclofen withdrawal in patients with unexplained hyperthermia and spasticity.