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.
MeSH terms
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Accidents, Traffic
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Administration, Oral
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Anti-Bacterial Agents / therapeutic use
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Baclofen / administration & dosage*
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Baclofen / adverse effects
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Catheter-Related Infections / microbiology*
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Catheters, Indwelling / adverse effects*
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Clonidine / administration & dosage
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Clonidine / analogs & derivatives
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Device Removal
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Drug Administration Schedule
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Humans
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Infusion Pumps, Implantable
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Infusions, Parenteral
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Male
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Middle Aged
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Muscle Relaxants, Central / administration & dosage*
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Muscle Relaxants, Central / adverse effects
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Paraplegia / drug therapy*
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Paraplegia / etiology
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Spinal Cord Injuries / complications
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Spinal Cord Injuries / drug therapy*
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Substance Withdrawal Syndrome / etiology
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Substance Withdrawal Syndrome / prevention & control*
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Treatment Outcome
Substances
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Anti-Bacterial Agents
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Muscle Relaxants, Central
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tizanidine
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Baclofen
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Clonidine