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巴氯芬与紧张症:病例报告。

Baclofen and catatonia: a case report.

机构信息

Medicine Department, Federal University of Santa Maria, Santa Maria, Brazil.

Medicine Department, American International Medical University, Gros Islet, Saint Lucia.

出版信息

Pan Afr Med J. 2022 Dec 21;43:198. doi: 10.11604/pamj.2022.43.198.38403. eCollection 2022.

Abstract

Baclofen was approved for medical use in the United States in 1977 by Food and Drug Administration. Serious adverse effects associated with this medication are uncommon at usually prescribed doses. Herein, we present a case of baclofen-induced catatonia in a young-adult female with back pain receiving oral baclofen. A 20-year-old female presented to the emergency department with possible seizure-like activity. It was reported that the patient was suffering from acute back pain and was prescribed baclofen three times a day by her general physician one day before her presentation. Upon further discussion, it was known that following an altercation with her family member, she had attempted suicide by consuming 200 mg of baclofen and then developed rapidly progressive symptoms of aphasia, mutism, and decreased oral intake. Laboratory tests, cerebrospinal fluid analysis, and neuroimaging were unremarkable. Electroencephalogram was normal. Bush-Francis Catatonia Rating Scale score was 27. She showed significant improvement following low-dose lorazepam administration. There are four reports in the literature of catatonia secondary to baclofen. The present report is the first to describe the occurrence of catatonia in a previously healthy individual. Analysis of these cases suggests a relationship between a history of psychotic symptoms and catatonia. All the reports were classified as probable by the Naranjo algorithm.

摘要

巴氯芬于 1977 年被美国食品和药物管理局批准用于医疗用途。在通常规定的剂量下,与这种药物相关的严重不良反应并不常见。在此,我们报告了一例因口服巴氯芬而导致背痛的年轻成年女性出现巴氯芬诱发的紧张症。一名 20 岁女性因疑似癫痫样发作到急诊科就诊。据报道,该患者患有急性背痛,她的全科医生在她就诊前一天给她开了每日三次的巴氯芬。进一步讨论后得知,在与家人发生争执后,她曾试图服用 200 毫克巴氯芬自杀,随后出现了迅速进展的言语障碍、缄默症和口腔摄入减少的症状。实验室检查、脑脊液分析和神经影像学检查均无异常。脑电图正常。布什-弗朗西斯紧张症评定量表评分为 27。她在接受低剂量劳拉西泮治疗后有明显改善。文献中有四起巴氯芬引起的紧张症的报告。本报告首次描述了在以前健康的个体中发生紧张症的情况。对这些病例的分析表明,精神病症状史与紧张症之间存在关系。所有报告均按 Naranjo 算法分类为可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0ac/10024567/d88288ccc871/PAMJ-43-198-g001.jpg

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