Iatrogenic Baclofen Neurotoxicity in End Stage Renal Disease: A Case Report and Review of Literature
Navaneedha Lingam Mahalingam, Rizna Abdul Cader
Journal of Advances in Medical and Pharmaceutical Sciences · pp. 1–4 · Published 30 Sep 2016
10.9734/JAMPS/2016/29261Abstract
Baclofen is a centrally acting antispasmodic agent that is commonly prescribed to patients suffering from spinal cord problems. Nearly 85% of baclofen is excreted by the kidneys whereas the remaining 15% is metabolized by the liver. In patients with renal insufficiency, baclofen accumulates and causes central nervous system toxicity. Herein we report a case of baclofen induced neurotoxicity in a patient with end stage renal disease on maintenance haemodialysis. The patient had cervical spondylomyopathy and was started on baclofen 10 mg once daily which was subsequently increased to three times a day. Within 48 hours of the increased dose of baclofen, he developed drowsiness, confusion and became aggressive. Other causes of encephalopathy were excluded and baclofen was stopped. His confusion improved completely after three consecutive sessions of haemodialysis. Physicians should be aware of baclofen induced neurotoxicity in patients with renal insufficiency.
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