Baclofen‑induced neurotoxicity in a dialysis patient managed with continuous venovenous hemodialysis: A case report and literature review
Nejah F. Ellouze
, Darpanarayan Hazra, Suad Al Abri
Department of Emergency Medicine, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
Keywords: Baclofen toxicity, continuous venovenous hemodialysis, end‑stage renal disease, neurotoxicity
Abstract
Despite documented cases of baclofen toxicity in individuals with kidney disease, the drug is widely prescribed for various medical conditions, primarily spasticity, hiccups, and multiple sclerosis. Baclofen, a gamma aminobutyric acid derivative, relies on renal excretion, rendering those with impaired kidney function susceptible to toxicity – a concern often underestimated by health care providers. Adverse reactions, including single or double doses, are well documented in addition to multi dose toxicity. This report discusses a case of baclofen induced neurotoxicity in an end stage renal disease patient undergoing dialysis, highlighting the subsequent management with continuous venovenous hemodialysis. In addition, it provides a comprehensive review of existing literature on baclofen toxicity in cases of renal insufficiency. Strikingly, the literature lacks clear guidelines regarding baclofen safety, dose adjustments, or renal function thresholds for contraindication. This contribution aims to augment understanding of this critical issue, emphasizing the need for heightened awareness and careful consideration of baclofen use in patients with kidney disease.
How to cite this article: Ellouze NF, Hazra D, Al Abri S. Baclofen-induced neurotoxicity in a dialysis patient managed with continuous venovenous hemodialysis: Acase report and literature review. Turk J Emerg Med 2024;24:176-9.
The authors confirm that they have acquired all necessary patient consent forms, including consent from the patient’s relatives, to share the patient’s clinical information in this journal report. The patient and her relatives acknowledge that the patient’s name and initials will not be disclosed, and every effort will be made to protect her identity, although complete anonymity cannot be assured.
NE: Conceptualization, data curation, methodology, resources, writing – original draft, writing – review, and editing. DH: Conceptualization, data curation, resources, writing – original draft, writing – review, and editing. SA: Conceptualization, investigations, methodology, project administration, supervision, writing – review, and editing.
None declared.
None.