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Baclofen encephalopathy: uncommon side effect of a common drug
  1. Abhishek Sachan,
  2. Varun Kumar Singh,
  3. Jayantee Kalita,
  4. Usha Kant Misra
  1. Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
  1. Correspondence to Professor Usha Kant Misra, Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, India; drukmisra{at}

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Baclofen (β-4-chlorophenyl gamma-amino butyric acid) is a natural derivative of neurotransmitter gamma-amino butyric acid (GABA). It is a centrally acting GABA(B) agonist and is used in treatment of spasticity, neuropathic pain, hiccups, alcohol withdrawal, opiate dependence and in a number of diseases like multiple sclerosis, spinal cord injuries and stroke. Baclofen can cause a variety of side effects such as sedation, somnolence, encephalopathy, coma, seizures, respiratory depression, flaccidity, areflexia and cardiac conduction defects.1 Rarely baclofen poisoning can result in acute encephalopathy which can be alarming and life threatening. In this communication, an elderly stroke patient developed severe encephalopathy following standard dose of baclofen,and is reported to increase the awareness about baclofen encephalopathy even on recommended doses.


A 75-year-old woman was admitted with symptoms of walking difficulty, decreased appetite and mild behavioural abnormality for last 2 months. She had diabetes and hypertension for 10 years and suffered from left sided ischaemic stroke 6 months ago. She was prescribed amlodipine 5 mg, metformin 1000 mg, aspirin 75 mg, clopidogrel 75 mg and alprazolam 0.5 mg once a day. On examination her weight was 55 kg, pulse rate 84/min, blood pressure 130/84 mm Hg, respiratory rate 14/min, temperature 98.2°F and blood glucose was 200 mg/dL. Her cardiorespiratory and abdominal examinations were normal. She was alert, cooperative and well …

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  • Contributors AS: patient management. VKS: patient supervision. JK: patient supervision and guidance. UKM: patient supervision and writing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.