Department of Pharmacy, Saint Joseph Health System, Lexington, KY 40504, USA.
Neurocrit Care. 2011 Feb;14(1):103-8. doi: 10.1007/s12028-010-9422-6.
Acute baclofen toxicity and withdrawal can present with a constellation of symptoms making differentiation between these two entities and other potential diagnoses challenging. Baclofen withdrawal is associated with numerous complications which may require neurocritical care expertise such as respiratory failure, refractory seizures, delirium, and blood pressure lability.
Case report and literature review.
This case report discusses a case of intrathecal baclofen (ITB) withdrawal, focusing on the differential diagnosis for acute baclofen withdrawal and reviews the various options that exist to treat the symptoms of acute baclofen withdrawal such as benzodiazepines, propofol, skeletal muscle relaxants, and tizanidine.
Critical care practitioners should be prepared to treat this potentially devastating and often refractory complication of ITB therapy.
急性巴氯芬中毒和戒断可表现出一系列症状,使得区分这两种情况和其他潜在诊断具有挑战性。巴氯芬戒断与许多并发症相关,这些并发症可能需要神经危重症专业知识,如呼吸衰竭、难治性癫痫发作、谵妄和血压不稳定。
病例报告和文献复习。
本病例报告讨论了一例鞘内巴氯芬(ITB)戒断的病例,重点讨论了急性巴氯芬戒断的鉴别诊断,并回顾了治疗急性巴氯芬戒断症状的各种选择,如苯二氮䓬类药物、丙泊酚、骨骼肌松弛剂和替扎尼定。
重症监护医生应该准备好治疗 ITB 治疗中这种潜在的破坏性且常常难治的并发症。