Korean J Nephrol.  2004 Mar;23(2):353-357.

A Case of Baclofen-Associated Encephalopathy in a Maintenance Hemodialysis Patient

• Choi MY
• Song HJ
• Kim MY
• Lee YS
• Kim SJ
• Choi KB
• Yoon KI
• Kang DH
• Park KD

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.

Keyword

Baclofen-associated encephalopathy; Hemodialysis

MeSH Terms

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
Baclofen
Creatinine
Neurotransmitter Agents
gamma-Aminobutyric Acid