0 84

Cited 0 times in

Successful Intrathecal Baclofen Therapy for Intractable Paroxysmal Sympathetic Hyperactivity in Patient with Pontine Hemorrhage: A case report

Authors
 Hyeon Su Kim  ;  Na Young Kim  ;  Yong Wook Kim 
Citation
 Clinical Neuropharmacology, Vol.41(4) : 138-141, 2018 
Journal Title
 Clinical Neuropharmacology 
ISSN
 0362-5664 
Issue Date
2018
Keywords
pontine hemorrhage ; paroxysmal sympathetic hyperactivity ; intrathecal baclofen therapy
Abstract
Paroxysmal sympathetic hyperactivity (PSH) is characterized by increased activity of the sympathetic nervous system. Although several treatments have been proposed for PSH, their efficacies are uncertain. We report a case of a patient with intractable PSH after pontine hemorrhage who was treated with intrathecal baclofen (ITB). A 61-year-old man was diagnosed with pontine hemorrhage expanding to the bilateral midbrain. Beginning 2 weeks after onset, he developed paroxysmal hyperthermia, tachycardia, tachypnea, hypertension, and generalized dystonic movements. Several medications were administered to the patient, including fentanyl patch, dantrolene, gabapentin, and β blockers. Nevertheless, PSH episodes continued to occur more than twice per day. Seven months after onset, we performed a trial of ITB injection, which led to reduced severity and frequency of PSH. Therefore, the ITB therapy was implanted. Continuous ITB was initiated at a rate of 100 μg/d, which was gradually increased up to 200 μg/d. Oral medications were tapered off. No PSH episode occurred for 4 weeks. Our findings suggest that ITB therapy may be used to manage intractable PSH. Intrathecal baclofen may inhibit postsynaptic activity and suppress sympathetic activity via the stimulation of γ-aminobutyric acid B receptors the brain.
Full Text
https://insights.ovid.com/pubmed?pmid=30001249
DOI
10.1097/WNF.0000000000000289
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
김나영(Kim, Na Young) ORCID logo https://orcid.org/0000-0001-9888-3953
김용욱(Kim, Yong Wook) ORCID logo https://orcid.org/0000-0002-5234-2454
Export
RIS (EndNote)
XLS (Excel)
XML
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163252
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse