A Case of Baclofen-Associated Encephalopathy in a Maintenance Hemodialysis Patient.
- Author:
Moon Young CHOI
1
;
Hyun Ju SONG
;
Mi Youn KIM
;
Young Sook LEE
;
Seung Jung KIM
;
Kyu Bok CHOI
;
Kyun Il YOON
;
Duk Hee KANG
;
Kee Duk PARK
Author Information
1. Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea. dhkang@ewha.ac.kr
- Publication Type:Case Report
- Keywords:
Baclofen-associated encephalopathy;
Hemodialysis
- MeSH:
Arm;
Baclofen;
Biochemistry;
Brain;
Brain Diseases, Metabolic;
Creatinine;
Electroencephalography;
Filtration;
Follow-Up Studies;
Frontal Lobe;
gamma-Aminobutyric Acid;
Hiccup;
Humans;
Middle Aged;
Multiple Sclerosis;
Neurologic Manifestations;
Neurotransmitter Agents;
Renal Dialysis*;
Renal Insufficiency;
Spasm;
Stupor
- From:Korean Journal of Nephrology
2004;23(2):353-357
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Baclofen, a derivative of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), is used for the treatment of muscle spasm, intractable hiccups and multiple sclerosis. It is mostly excreted by glomerular filtration with a clearance that is proportional to creatinine clearance. Early hemodialysis is a treatment of the choice for baclofen-induced neurologic complication in renal failure patients. We experienced a 57-year-old hemodialysis patient with right arm muscle spasm who developed baclofen-associated encephalopathy by a single dose of oral baclofen (10 mg). He admitted to the hospital with the symptom of stuporous mental status with no specific focal neurologic signs. Brain CT imaging and blood biochemistry showed no specific abnormality. EEG revealed the typical metabolic encephalopathy findings, such as triphasic wave and frontal lobe syndrome with delta wave. After daily hemodialysis for 3 days, there was a complete recovery of an altered mentality. After one month later, the follow-up EEG showed normal finding with the resolution of abnormal waves. We report this case with a review of relevant literature. Baclofen should be used carefully, and rather recommended not to be administered in patients with renal failure.
