| Cyproheptadine for pediatric intrathecal baclofen withdrawal: a case report. | |
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MedLine Citation:
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PMID: 18090440 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Joseph A Saveika; Jean E Shelton |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: American journal of physical medicine & rehabilitation / Association of Academic Physiatrists Volume: 86 ISSN: 0894-9115 ISO Abbreviation: Am J Phys Med Rehabil Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-12-19 Completed Date: 2008-01-14 Revised Date: 2009-02-26 |
Medline Journal Info:
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Nlm Unique ID: 8803677 Medline TA: Am J Phys Med Rehabil Country: United States |
Other Details:
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Languages: eng Pagination: 994-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Physical Medicine and Rehabilitation, Eastern Virginia Medical School, Norfolk, Virginia 23507, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Age Factors Baclofen / administration & dosage, pharmacology* Cerebral Palsy / drug therapy Child Cyproheptadine / therapeutic use* Equipment Failure Female GABA Agonists / administration & dosage, pharmacology* Histamine H1 Antagonists / therapeutic use* Humans Infusion Pumps Injections, Spinal / instrumentation Pruritus / etiology Quadriplegia / drug therapy Substance Withdrawal Syndrome / drug therapy* |
| Chemical | |
Reg. No./Substance:
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0/GABA Agonists; 0/Histamine H1 Antagonists; 1134-47-0/Baclofen; 129-03-3/Cyproheptadine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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