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Epileptic seizures associated with intrathecal baclofen application

Department of Neurology (Drs. Kofler, Kronenberg, Rifici, Saltuari, and Bauer), University of Innsbruck, Austria: the Division of Restorative Neurology and Human Neurobiology (Dr. Kronenberg), Baylor College of Medicine, Houston, Tx, and the Centro Neurolesi (Dr. Rifici), University of Messina, Italy.

We report the clinical and EEG findings in three patients presenting with seizures associated with intrathecal baclofen application for treatment of spasticity. All patients had a history of traumatic brain injury, while one patient also suffered a spinal cord injury. Two patients experienced their first seizure following intrathecal baclofen test bolus injection. Another patient had convulsions on two occasions: following postoperative baclofen dose adjustment, and after sleep deprivation. Structural brain disease seems prerequisite for baclofen to exert epileptogenic activity, since seizures have not occurred in patients receiving intrathecal baclofen for spasticity of solely spinal origin. Antiepileptic medication permitted the continuation of intrathecal baclofen treatment in the three patients.

Address correspondence and reprint requests to Dr. Markus Kofler, Department of Neurology, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.

Received January 6, 1993. Accepted for publication in final form July 20, 1993

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