Intrathecal baclofen withdrawal: A rare cause of reversible cardiomyopathy

Acute Card Care. 2016 Mar;18(1):13-17. doi: 10.3109/17482941.2016.1174273. Epub 2016 Sep 28.

Abstract

Baclofen is commonly used to treat spasticity of central etiology. Unfortunately, a potentially lethal withdrawal syndrome can complicate its use. This is especially true when the drug is administered intrathecally. There are very few cases of baclofen withdrawal leading to reversible cardiomyopathy described in the literature. The authors present a patient with a history of chronic intrathecal baclofen use who, in the setting of acute baclofen withdrawal, develops laboratory, electrocardiogram, and echocardiogram abnormalities consistent with cardiomyopathy. Upon reinstitution of intrathecal baclofen, the cardiomyopathy and associated abnormalities quickly resolve. Although rare, it is crucial to be aware of this reversible cardiomyopathy to ensure its prompt diagnosis and treatment.

Keywords: Cardiomyopathy; baclofen withdrawal; echocardiography; reversible.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Baclofen* / administration & dosage
  • Baclofen* / adverse effects
  • Cardiomyopathies* / chemically induced
  • Cardiomyopathies* / diagnosis
  • Cardiomyopathies* / physiopathology
  • Cardiomyopathies* / therapy
  • Catheterization, Swan-Ganz / methods
  • Coronary Angiography / methods
  • Echocardiography / methods
  • Equipment Failure
  • Humans
  • Infusion Pumps, Implantable / adverse effects*
  • Infusions, Spinal / instrumentation
  • Infusions, Spinal / methods
  • Intra-Aortic Balloon Pumping / methods*
  • Male
  • Muscle Relaxants, Central / administration & dosage
  • Muscle Relaxants, Central / adverse effects
  • Quadriplegia / drug therapy*
  • Substance Withdrawal Syndrome* / diagnosis
  • Substance Withdrawal Syndrome* / etiology
  • Substance Withdrawal Syndrome* / physiopathology
  • Substance Withdrawal Syndrome* / therapy
  • Treatment Outcome

Substances

  • Muscle Relaxants, Central
  • Baclofen