Intravenous diazepam infusion in the management of planned intrathecal baclofen withdrawal

Intrathecal baclofen is used in the management of spasticity associated with cerebral palsy (CP). Sudden cessation of intrathecal baclofen may give rise to the potentially life‐threatening baclofen withdrawal syndrome. We report three cases in which intravenous diazepam is used effectively in the management of planned intrathecal withdrawal. All three patients had CP. In the first patient, a 19‐year‐old male with quadriplegia, the intrathecal catheter had to be removed. The other two patients, an 11‐year‐old female with diplegia and a 16‐year‐old male with quadriplegia, both required the entire device to be removed. The purpose of this case report is to illustrate the potential management for elective cases in a similar situation.

[1]  N. Zuckerbraun,et al.  Intrathecal Baclofen Withdrawal: Emergent Recognition and Management , 2004, Pediatric emergency care.

[2]  M. Tsegaye,et al.  Treatment of childhood spasticity of cerebral origin with intrathecal baclofen: a series of 52 cases , 2004, British journal of neurosurgery.

[3]  M. Greenberg,et al.  Baclofen Withdrawal Following Removal of an Intrathecal Baclofen Pump Despite Oral Baclofen Replacement , 2003, Journal of toxicology. Clinical toxicology.

[4]  J. Ojemann,et al.  Intrathecal baclofen withdrawal: a case report and review of the literature , 2002, Child's Nervous System.

[5]  R. Coffey,et al.  Abrupt withdrawal from intrathecal baclofen: recognition and management of a potentially life-threatening syndrome. , 2002, Archives of physical medicine and rehabilitation.

[6]  L. Krach,et al.  Intrathecal Baclofen for Management of Spastic Cerebral Palsy: Multicenter Trial , 2000, Journal of child neurology.

[7]  V. Nelson,et al.  Death after acute withdrawal of intrathecal baclofen: case report and literature review. , 1999, Archives of physical medicine and rehabilitation.

[8]  R. Reeves,et al.  Hyperthermia, rhabdomyolysis, and disseminated intravascular coagulation associated with baclofen pump catheter failure. , 1998, Archives of physical medicine and rehabilitation.

[9]  D. Cochrane,et al.  Intrathecally administered baclofen for treatment of children with spasticity of cerebral origin. , 1997, Journal of neurosurgery.

[10]  R. Penn,et al.  Intrathecal baclofen down-regulates GABAB receptors in the rat substantia gelatinosa. , 1993, Journal of neurosurgery.

[11]  R. Penn,et al.  INTRATHECAL BACLOFEN ALLEVIATES SPINAL CORD SPASTICITY , 1984, The Lancet.