Adverse Side Effect of Baclofen: Case Report

Baclofen(B-4-chlorphyl-r-amino butyric acid), a centrally acting gamma amino butyric acid (GABA) agonist is a commonly used pharmaceutics for spasticity of spinal cord lesion. It's effect includes activation of GABA recep tor in primary sensory afferent, enhancement of Ranshow cell activity and depression of fusimotor response. It is primarily excreted by glomerullar filtration with a clearance proportional to creatinine clearance. It's popularity is a result of the antispastic effect and the lack of toxic effect on organ. But, transient drowsiness is the most common neurological side effect with therapeutic dose of the drugs. We report here two patients who developed an acute side effects after being treated with relative therapeutic dose of baclofen.

The Trends of Urinary Tract Infection in Patients with Neurogenic Bladder

The urinary tract infection(UTI) is a very common complication of rehabilitation patients with neurogenic bladder. Proper diagnosis and early treatment are very important for the long term rehabilitation outcomes. Many reports are available in the literature on the characteristics of UTI in spinal cord injury(SCI) patients, however only few reports appear on non-SCI patients. We have done comprehensive chart reviews of 1,251 patients with neurogenic bladder who were admitted to the rehabilitation medicine department, PMC from January 1982 to August 1996. Patients were divided into 4 groups: patients with stroke, spinal cord injury, traumatic brain injury and other neurologic diseases, and we have studied: incidence of UTI, commonly cultured organisms, antibiotic sensitivities, urinary pH, voiding methods, and residual urine volumes. The incidences of UTI are 50.9% for all patients, 48.1% in Stroke, 72.3% in Spinal cord injury, 38.9% in Traumatic brain injury, and 34.1% in other neurologic diseases. There has been increase of Gram(+) cocci and decrease of Gram(-) rod during study period. Commonly cultured organisms are Escherichia coli(E. coli), Pseudomonas, Klebsiella. The decreased antibiotic sensitivities are noted in almost all organisms. Positive correlations are found between the incidence of UTI, high urine pH, high residual urine volumes, and use of catheters. In conclusion, despite of many variable factors, the trends of UTI in each groups show no significant difference.