Prevention of intrathecal baclofen withdrawal syndrome: successful use of a temporary intrathecal catheter.

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.