Cyproheptadine for pediatric intrathecal baclofen withdrawal: a case report.

Abstract:

:Intrathecal baclofen withdrawal syndrome is a known complication of intrathecal baclofen pumps. Its origin is postulated as an independent form of a serotonergic syndrome occurring from loss of gamma-aminobutyric acid B receptor-mediated inhibition of serotonin. Prodromal symptoms include pruritus, a return of deep tendon reflexes, and increased spastic hypertonia. Previous reports have documented use of cyproheptadine in treatment of this syndrome in adults with positive results. We present the case of a 14-yr-old child with cerebral palsy who developed pruritus and worsening spastic hypertonia 18 mos after pump implantation. She had been previously treated with 520 microg/day of intrathecal baclofen. Progression of her symptoms was successfully arrested by the administration of both oral and intrathecal baclofen and 6 mg of oral cyproheptadine every 6 hrs for 1 day. We postulate that cyproheptadine should be considered a valuable adjuvant therapy for treatment of suspected intrathecal baclofen withdrawal syndrome.

journal_name

Am J Phys Med Rehabil

authors

Saveika JA,Shelton JE

doi

10.1097/PHM.0b013e31815b5c58

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

994-7

issue

12

eissn

0894-9115

issn

1537-7385

pii

00002060-200712000-00006

journal_volume

86

pub_type

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