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Case report
Ref Number: APCP-PP-161

Severe bradycardia in a 12-year-old with spastic quadriplegic cerebral palsy (GMFCS V) associated with oral baclofen therapy

Ajantha Vikum Abeysekara¹, Damitha Chandradasa¹, Yuresha Surangani¹
1- Teaching Hospital Anuradhapura, Sri Lanka
Corresponding Author: Ajantha Vikum Abeysekara (vikum111@gmail.com)
Abstract Body
Background: Baclofen is widely used to treat spasticity . Although central nervous system depression is the most commonly described manifestation of baclofen toxicity , cardiovascular effects including bradycardia and conduction abnormalities have been reported. Case A: 12-year-old boy with spastic quadriplegic cerebral palsy (GMFCS V) on multiple antispastic medications (oral baclofen, benzhexol/trihexyphenidyl, and Syndopa) was found to have severe bradycardia and poor peripheral perfusion during routine admission for nasogastric (NG) tube change. Blood pressure was noted to be around 50th centile. There was no history of recent infection, dehydration, or medication dose change. Initial ECG showed sinus arrhythmia. Laboratory investigations were normal. Baclofen was omitted and within 6 to 8 hours heart rate returned to baseline with improved perfusion. Conclusion: Baclofen toxicity or drug sensitivity may present with cardiovascular depression. Early recognition and withdrawal of the drug can result in rapid clinical improvement.
Keywords: Cerebral palsy gmfcs; Oral baclofen therapy; Baclofen toxicity
Presentation Type: Case report
Disclaimer: The Views and opinions expressed in the articles are of the authors and not of the journal.
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