Original Article
Spinal Cord (2009) 47, 477–480; doi:10.1038/sc.2008.156; published online 16 December 2008
Delirium secondary to intrathecal baclofen
B Castaño1, J Benito1, F Pires2, S Ferreira3, R Lopez1 and J Vidal1
- 1Institut Guttmann, Neurorehabilitation Hospital, Spinal Cord Injury Unit, Badalona, Spain
- 2Hospital São João, Porto, Portugal
- 3Hospital Senhora da Oliveira, Guimarães, Portugal
Correspondence: Dr B Castaño, Instituto Guttmann, Cami Can Ruti s/n, Neurorehabilitation Hospital, 08916 Badalona, Spain. E-mail: bcastano@guttmann.com
Received 20 May 2008; Revised 12 November 2008; Accepted 16 November 2008; Published online 16 December 2008.
Abstract
Study design:
Retrospective study based on a revision of the clinical histories of all patients carrying an intrathecal baclofen (ITB) infusion system between July 1988 and March 2007 in a neurorehabilitation hospital.
Objectives:
To describe the psychiatric manifestations due to intoxication or withdrawal of ITB and to explore the possible risk factors for the presentation of delirium secondary to baclofen.
Setting:
Spinal Cord Injury Unit in Barcelona, Spain.
Methods:
We selected patients who presented delirium related to baclofen treatment. We filtered these cases by the search of key words. All the compatible episodes were then reviewed and positive cases were confirmed to perform a descriptive analysis of the different variables. Control subjects were randomly selected for a comparative analysis of the aspects of interest.
Results:
A total of 12 of the 126 patients carrying the intrathecal system in our hospital presented delirium related to baclofen. Eight cases due to intoxication (66.6%) and four due to withdrawal (33.3%) were found. We provide a description of the psychiatric symptoms. There were no fatal cases due to delirium.
Conclusion:
Delirium has a frequency of 9.5% in patients carrying the ITB infusion system, intoxication being more frequent than withdrawal.
Keywords:
spasticity, baclofen, withdrawal, intoxication, delirium
