Baclofen and Consciousness Disorders in Chronic Hemodialysis: A Case Report

Baclofen is a chlorophenyl derivative of gamma-aminobutyric acid, which is ubiquitous in the central nervous system and which is the main inhibitory neurotransmitter of the Central Nervous System. Overdose of Baclofen treatment can be life-threatening for the patient. We report the case of a 58-year-old patient with a history of hypertension. He was treated with COVERAM 10/10, Physiotens 0.4. He has been on chronic hemodialysis for three years for nephroangioslerosis. The patient was admitted to the hospital by his neurologist for disturbances in alertness after administration of Baclofen 120 mg/day orally for neuromuscular pain. Clinically he had disturbances of consciousness (Glasgow score of 10) without signs of neurological focalization. Hemodynamic constants were normal. The biological assessment revealed chronic end-stage renal failure with Cockcroft clearance at 2 ml/min. The electrocardiogram was without abnormality. Chest x-ray, brain CT scan and lumbar puncture were normal. The electroencephalogram showed diffuse slowing. A probable drug poisoning was mentioned. A 4-hour hemodialysis session was undertaken with a favorable clinical outcome. The objective of our work was to provide our experience on a case of Baclofen poisoning occurring in a chronic hemodialysis patient in the nephrology department of Point “G” University Hospital.