SEROTONIN SYNDROME MIMICKING INTRATHECAL BACLOFEN WITHDRAWAL IN A PATIENT WITH HEREDITARY SPASTIC PARAPARESIS

Goffin, Nicolas;Nguyen, Virginie;Fostier, Michèle;Gustin, Thierry;Deltombe, Thierry
(2019) Journal of rehabilitation medicine clinical communications — Vol. 3 (2020) (2020)

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Context: Serotonin syndrome is a drug-induced condition related to an increased level of serotonin in the brain, which may induce neuromuscular, autonomic 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 reuptake may induce serotonin syndrome, resulting in increased spasticity in patients with spinal cord lesions, and should be prescribed with caution.
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Goffin, N., Nguyen, V., Fostier, M., Gustin, T., & Deltombe, T. (2019). SEROTONIN SYNDROME MIMICKING INTRATHECAL BACLOFEN WITHDRAWAL IN A PATIENT WITH HEREDITARY SPASTIC PARAPARESIS. Journal of rehabilitation medicine clinical communications, 3 (2020). https://doi.org/10.2340/20030711-1000026 (Original work published 2020)