Pathak Lakshmi Kant, Athavale Ambarish, Martinez Ian
Department of Nephrology, University of Illinois at ChicagoChicagoIllinois.
Department of Nephrology, Cook County Health and Hospital SystemChicagoIllinois.
Proc (Bayl Univ Med Cent). 2019 Jun 21;32(3):425-426. doi: 10.1080/08998280.2019.1618659. eCollection 2019 Jul.
Baclofen is approved by the Food and Drug Administration for spasticity and is also used off-label for trigeminal neuralgia, cluster headache, and substance abuse dependency. Baclofen is 90% renally excreted and has a variable threshold for toxicity in patients with chronic kidney disease. We present a case of accidental overdose of baclofen in a 58-year-old woman with intractable trigeminal neuralgia. She presented with baclofen neurotoxicity symptoms including confusion and tremors and had a morbilliform rash in the dorsum of both hands. This simultaneous presentation is rare and has never been reported. Her symptoms resolved after hemodialysis treatment.
巴氯芬已获美国食品药品监督管理局批准用于治疗痉挛,也被用于治疗三叉神经痛、丛集性头痛和药物滥用依赖等未获批的适应症。巴氯芬90%经肾脏排泄,在慢性肾病患者中其毒性阈值存在个体差异。我们报告一例58岁患有顽固性三叉神经痛的女性意外过量服用巴氯芬的病例。她出现了包括意识模糊和震颤在内的巴氯芬神经毒性症状,双手背部有麻疹样皮疹。这种同时出现的症状很罕见,此前从未有过报道。经血液透析治疗后,她的症状得到缓解。