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Neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function

Patients with brain death have by definition irreversible and complete loss of brainstem reflexes. Before a definite diagnosis of brain death can be confirmed, all potential confounders must be thoroughly excluded. Baclofen intoxication is a rare cause of brain death mimic characterised by transient...

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Autores principales: Berger, Sebastian, Kuster, Tobias, Sutter, Raoul, Fisch, Urs
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10565328/
https://www.ncbi.nlm.nih.gov/pubmed/37802597
http://dx.doi.org/10.1136/bcr-2023-257391
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author Berger, Sebastian
Kuster, Tobias
Sutter, Raoul
Fisch, Urs
author_facet Berger, Sebastian
Kuster, Tobias
Sutter, Raoul
Fisch, Urs
author_sort Berger, Sebastian
collection PubMed
description Patients with brain death have by definition irreversible and complete loss of brainstem reflexes. Before a definite diagnosis of brain death can be confirmed, all potential confounders must be thoroughly excluded. Baclofen intoxication is a rare cause of brain death mimic characterised by transient deep coma and absence of brainstem reflexes and might be mistaken with brain death. We report the case of a female patient in her 70s who ingested baclofen with suicidal intent and was admitted with a deep coma and loss of all brainstem reflexes and a spontaneous burst-suppression pattern in the electroencephalography which resolved over 10 hours. After a state mimicking brain death for 6 hours, the patient experienced complete recovery. Severe baclofen intoxication can mimic brain death clinically and is associated with temporary pathological electroencephalographic findings. Awareness of this toxidrome is crucial, as appropriate management can lead to full recovery.
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spelling pubmed-105653282023-10-12 Neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function Berger, Sebastian Kuster, Tobias Sutter, Raoul Fisch, Urs BMJ Case Rep Critical Care Patients with brain death have by definition irreversible and complete loss of brainstem reflexes. Before a definite diagnosis of brain death can be confirmed, all potential confounders must be thoroughly excluded. Baclofen intoxication is a rare cause of brain death mimic characterised by transient deep coma and absence of brainstem reflexes and might be mistaken with brain death. We report the case of a female patient in her 70s who ingested baclofen with suicidal intent and was admitted with a deep coma and loss of all brainstem reflexes and a spontaneous burst-suppression pattern in the electroencephalography which resolved over 10 hours. After a state mimicking brain death for 6 hours, the patient experienced complete recovery. Severe baclofen intoxication can mimic brain death clinically and is associated with temporary pathological electroencephalographic findings. Awareness of this toxidrome is crucial, as appropriate management can lead to full recovery. BMJ Publishing Group 2023-10-06 /pmc/articles/PMC10565328/ /pubmed/37802597 http://dx.doi.org/10.1136/bcr-2023-257391 Text en © BMJ Publishing Group Limited 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Critical Care
Berger, Sebastian
Kuster, Tobias
Sutter, Raoul
Fisch, Urs
Neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function
title Neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function
title_full Neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function
title_fullStr Neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function
title_full_unstemmed Neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function
title_short Neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function
title_sort neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function
topic Critical Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10565328/
https://www.ncbi.nlm.nih.gov/pubmed/37802597
http://dx.doi.org/10.1136/bcr-2023-257391
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