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CASE REPORT
Prevention of Intrathecal Baclofen Withdrawal Syndrome: Successful Use of a Temporary Intrathecal Catheter
  1. Anke Bellinger, MD*,
  2. Rapipen Siriwetchadarak, MD*,
  3. Richard Rosenquist, MD* and
  4. Jeremy D.W. Greenlee, MD†
  1. From the Departments of *Anesthesia, and
  2. †Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA.
  1. Address correspondence to: Anke Bellinger, MD, Department of Anesthesia, 200 Hawkins Dr, 6-JCP, Iowa City, IA 62242 (e-mail: Anke-Bellinger{at}uiowa.edu).

Abstract

Abrupt cessation of intrathecal baclofen (ITB) administration can cause a life-threatening withdrawal syndrome that requires prompt diagnosis and urgent treatment. The current therapy for this condition is administration of propofol, benzodiazepines, paralytics and supportive care. This study reports a 53-year-old patient with paraplegia with an ITB infusion who presented with an infected pump site. The pump and the catheter were surgically removed and replaced with a temporary externalized intrathecal catheter. The ITB infusion was tapered and simultaneously substituted with progressively higher doses of oral antispasmotics. With this strategy, we were able to avoid life-threatening complications.

https://doi.org/10.1097/AAP.0b013e3181b4cc6b

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