Infusion of intrathecal baclofen for acute withdrawal. Technical note.

Acute baclofen withdrawal syndrome is a life-threatening situation that demands early recognition and urgent treatment. The current therapy of choice for this syndrome is administration of intravenous benzodiazepines, propofol, and chemical paralytic drugs until the intrathecal system can be restored. The authors present a novel technique for administering baclofen intrathecally using a lumbar drain and a standard patient-controlled analgesia pump (in continuous infusion mode). In one case, this method was used to wean the patient from high-dose intrathecal baclofen treatment. In a second case, this method was used as a temporizing measure until the indwelling pump system could be repaired. In both cases, the patients recovered to their neurological baseline level, and lasting consequences of serious withdrawal were avoided.