Serotonin syndrome mimicking intrathecal baclofen withdrawal in a patient with hereditary spastic paraparesis

Authors

  • Nicolas Goffin
  • Virginie Nguyen
  • Michèle Fostier
  • Thierry Gustin
  • Thierry Deltombe

DOI:

https://doi.org/10.2340/20030711-1000026

Keywords:

serotonin syndrome, hereditary spastic paraparesis, intrathecal baclofen, paroxetine.

Abstract

Context: Serotonin syndrome is a drug-induced condition related to an increased level of serotonin in the brain, which may induce neuromuscular, auto-nomic and mental symptoms. Case report: A 40-year-old woman with hereditary spastic paraparesis (Strumpell-Lorrain disease) with an implanted intrathecal baclofen pump for severe spasticity. Two days after starting a medication known to inhibit serotonin re-uptake (paroxetine), she developed a sudden increase in lower limb spasticity with continuous spasms, fever, tachycardia and hypertension. Intrathecal baclofen withdrawal was excluded, confirming serotonin syndrome. Conclusion: Medications that inhibit serotonin re-uptake may induce serotonin syndrome, resulting in increased spasticity in patients with spinal cord lesions, and should be prescribed with caution.

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Published

2020-01-21

How to Cite

Goffin, N., Nguyen, V., Fostier, M., Gustin, T., & Deltombe, T. (2020). Serotonin syndrome mimicking intrathecal baclofen withdrawal in a patient with hereditary spastic paraparesis. Journal of Rehabilitation Medicine - Clinical Communications, 3, 1–4. https://doi.org/10.2340/20030711-1000026

Issue

Section

Case Report