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A 38-Year-Old Woman with Baclofen Withdrawal

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Practical Chronic Pain Management

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Abstract

Intrathecal baclofen is an effective treatment for patients suffering from significant spasticity secondary to multiple sclerosis (MS). Intrathecal drug delivery systems (IDDS) are an effective way to deliver intrathecal baclofen safely; however, risks still exist. Increased spasticity in a patient with a baclofen IDDS needs to be worked up promptly for underlying disease modifiers as well as IDDS-related issues. IDDS-related issues include improper programming, incorrect drug concentration, catheter-related issues, and rotor failure. One should be vigilant for signs and symptoms of baclofen withdrawal and treat promptly to avoid serious sequelae including death. Current treatment for intrathecal baclofen withdrawal, including oral baclofen and use of benzodiazepines, is inadequate necessitating resumption of intrathecal therapy. Studies are ongoing to develop a safe intravenous (IV) formulation of baclofen. It is unclear how effective this will be in the treatment of intrathecal baclofen withdrawal.

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Authors and Affiliations

  1. Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA, USA

    Lynn R. Kohan & Xiaoying Zhu

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  1. Lynn R. Kohan
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  2. Xiaoying Zhu
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Correspondence to Lynn R. Kohan .

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Editors and Affiliations

  1. Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL, USA

    Tariq Malik

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Kohan, L.R., Zhu, X. (2020). A 38-Year-Old Woman with Baclofen Withdrawal. In: Malik, T. (eds) Practical Chronic Pain Management. Springer, Cham. https://doi.org/10.1007/978-3-030-46675-6_44

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  • DOI: https://doi.org/10.1007/978-3-030-46675-6_44

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-46674-9

  • Online ISBN: 978-3-030-46675-6

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