Ver el código de «Baclofen withdrawal»

==Background==
*[[Baclofen]] (Lioresal) is an anti-spasmodic that works on the as a GABA-B agonist
*Primarily used in patients with [[multiple sclerosis]], [[cerebral palsy]], and spinal cord injuries
*Often administered intrathecally but does have an oral formulation
*Withdrawal symptoms thought to be caused by decreased GABA activation

==Clinical Features==
Baclofen withdrawal especially in the case of acute intrathecal pump failure may lead to:
*High [[fever]]s
*[[Confusion]], altered mental status
*Muscle stiffness
*[[Seizures]]
*[[Rhabdomyolysis]] 
*Multiple organ system failure
*Death

==Differential Diagnosis==
*[[Sepsis]]
*[[Meningitis]]
*[[Epilepsy]]
*Autonomic dysreflexia 
*[[Neuroleptic malignant syndrome]] 
*[[Malignant hyperthermia]]

{{Template:Sedative/hypnotic withdrawal types}}

==Evaluation==
*History of baclofen use
*Physical exam
*Examination of the pump
*CPK levels
*Electrolytes
*CBC 
*[[LFTs]] 
*Coagulation studies

==Management==
*High doses of [[benzodiazepines]] are the mainstay of treatment
*High dose oral baclofen has been used but has been less effective
*Intrathecal baclofen bolus can be attempted but overdoses are possible with this method
*[[Dantrolene]] and [[cyproheptadine]] can also be considered but their efficacy is still unproven in this situation

==Disposition==
Admit:
*Organ failure
*[[Status epilepticus]]
*Pump malfunction
*Fever
*Loss of consciousness

==See Also==
*[[Cerebral palsy]]
*[[Baclofen toxicity]]
*[[Baclofen]]

==External Links==

==References==
<references/>

[[Category:Toxicology]]