Universität zu Köln

Weisshaar, Guido F., Hoemberg, Marc, Bender, Katja, Bangen, Ursula, Herkenrath, Peter, Eifinger, Frank ORCID: 0000-0003-1758-6039, Rothschild, Markus, Roth, Bernhard and Oberthuer, Andre (2012). Baclofen intoxication: a fun drug causing deep coma and nonconvulsive status epilepticus-a case report and review of the literature. Eur. J. Pediatr., 171 (10). S. 1541 - 1548. NEW YORK: SPRINGER. ISSN 0340-6199

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Abstract

The number of reports on baclofen intoxication has increased in recent years. We report a 15-year-old boy who was referred in a state of deep coma (Glasgow Coma Scale = 3). On clinical examination, he showed sinus bradycardia with normal blood pressure. On admission to the hospital, he presented intermittent short episodes of generalized tonic-clonic seizures. While results of imaging procedures and initial toxicological screening (including standard HPLC analysis and urine test) were negative, a nonconvulsive status epilepticus was diagnosed by electroencephalography (EEG). Identification of baclofen as causative agent was possible after the boy's father reported abusive baclofen intake. Subsequent toxicological target analysis of blood and urine samples confirmed the excessive intake of baclofen and showed a typical elimination pattern with a secondary release. Following 112 h of mechanical ventilation, the boy rapidly regained consciousness and recovered normal neurological behavior. Conclusions: The present case demonstrates the importance of considering baclofen overdosage in cases of severe coma in combination with an abnormal EEG pattern and sinus bradycardia with normal blood pressure levels, in particular as the substance is popular in internet reports promoting baclofen as a rather harmless fun drug. Furthermore, it underlines the difficulty to identify baclofen as a causative agent without anamnestic information. Nevertheless, by reviewing existing literature on oral baclofen overdosage, it is possible to picture a nearly specific pattern of clinical symptoms in baclofen intoxication.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Weisshaar, Guido F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoemberg, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Bender, Katja UNSPECIFIED UNSPECIFIED UNSPECIFIED Bangen, Ursula UNSPECIFIED UNSPECIFIED UNSPECIFIED Herkenrath, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Eifinger, Frank UNSPECIFIED orcid.org/0000-0003-1758-6039 UNSPECIFIED Rothschild, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Roth, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Oberthuer, Andre UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-481888
DOI:	10.1007/s00431-012-1780-y
Journal or Publication Title:	Eur. J. Pediatr.
Volume:	171
Number:	10
Page Range:	S. 1541 - 1548
Date:	2012
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	0340-6199
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MIMICKING BRAIN-DEATH; ORAL BACLOFEN; OVERDOSE; LIORESAL; INGESTION; SPASTICITY; KINETICS; CHILD; PHARMACOKINETICS; PHYSOSTIGMINE Multiple languages Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48188