Kontinuierliche intrathekale Verabreichung von Baclofen bei generalisiertem Tetanus

Zusammenfassung.

Fallbericht eines 71-jährigen Mannes mit generalisierter Tetanusverlaufsform. Der Patient wurde anfänglich konventionell mit sedierenden und relaxierenden Medikamenten behandelt, was eine Intubation und Beatmung erforderlich machte. Nach intrathekaler Verabreichung von Baclofen sistierte jede Krampfneigung und der Patient konnte vom Respirator entwöhnt und im weiteren Verlauf von der Intensivstation entlassen werden.

Continuous Intrathecal Administration of Baclofen in Severe Tetanus.

This is a case report involving a 71 year old man with generalized tetanus. The patient was initially treated conservatively with sedatives and muscle relaxants, which necessitated intubation and mechanical ventilation. After intrathecal administration of baclofen all cramps and spasms subsided and the patient could be weaned from the respirator and subsequently discharged from the intensive care unit.

Schlüsselwörter:

Tetanus - Spinalkatheter - Baclofen

Key words:

Tetanus - Intrathecal-catheter - Baclofen

Literatur

• 1 Stanford J P. Tetanus - Forgotten but not gone.  The New England Journal of Medicine.. March, 23, 1995;  332 12
• 2 Bademosi O. Geographical variations in neurological disease.  Africa, Oxford Textbook of Medicine. Edited by Weatherall DJ, Ledingham JGG,Warrel DA. New York, Oxford University Press. 1990;  2nd Ediditon 21 272-276
• 3 Engrand N, Guerot E, Rouamba A. The efficacy of intrathecal baclofen in severe Tetanus.  Anesthesiology. 1999;  90 1773-1776
• 4 Dressnandt J, Konstanzer A, Weinzierl F X. Intrathecal baclofen in tetanus: four cases and a review of reported cases.  Intensive Care Med.. 1997;  23 (8) 896-902
• 5 Francois B, Clavel M, Desachy A. Continuous intrathecal injection of baclofen in generalized tetanus. A therapeutic alternative.  Presse Med.. 1997;  28; 26 1045-1047
• 6 Brock H, Moosbauer W, Gabriel C. Treatment of severe tetanus by continuous intrathecal infusion of baclofen.  J Neurol Neurosurg Psychiatry.. 1995;  59 (2) 193-194
• 7 Sallerin-Caute B, Lazorthes Y, Monsarrat B. CSF baclofen levels after intrathecal administration in severe spasticity.  Eur. J. Clin. Pharmacol.. 1991;  40 363-365
• 8 Penn R D, Kroin J S. Intrathecal baclofen (letter).  N. Engl. J. Med.. 1989;  321 1414-1415
• 9 Pellanda A, Caldiroli D, Vaghi G M. Treatment of severe tetanus by intrathecal infusion of baclofen.  Intensive Care Med.. 1993;  19 (1) 59
• 10 Saissy J, Demaziere J, Vitris M, Seck M. Treatment of severe tetanus by intrathecal injections of baclofen without artilicial ventilation.  Intensive Care Med.. 1992;  18 (4) 241-244
• 11 Muller H, Borner U, Zierski J. Intrathecal baclofen in tetanus.  Lancet.. 1996;  8; 1 (8476) 317-318