Annals of B-Pod: Baclofen Pump Failure

Annals of B-Pod: Baclofen Pump Failure

Muscle relaxants see a wide variety of uses in the emergency department. From the treatment of sprains and strains to the management of spasticity in patients with upper motor neuron disease, agents like baclofen, cyclobenzaprine, and methocarbamol are well-established elements of an emergency physician’s armamentarium. With prolonged utilization, however, patients may develop dependence on these agents. Furthermore, this dependence may progress to potentially life-threatening withdrawal symptoms should the muscle relaxants be abruptly discontinued. In this article, Dr. Gottula walks us through the presentation and management of a patient suffering from a severe baclofen withdrawal following the failure of her intrathecal pump, including a discussion of the underlying pathophysiology and diagnostic considerations in the emergency department.

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