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Hallucinations after Preoperative Baclofen Discontinuation in Spinal Cord Injury Patients

Baclofen is a muscle relaxant approved in this country for the treatment of muscle spasms secondary to multiple sclerosis, spinal cord injury, and other spinal diseases. Although baclofen is considered to have fewer side effects than alternative drugs, problems can occur when the dosage is changed abruptly. Two patients are presented who developed hallucinations after discontinuing baclofen as part of routine preoperative procedures. Both patients responded at 23 and 31 hours after reinstituting baclofen. If possible, patients should be withdrawn slowly from baclofen before surgery. Any patient withdrawn abruptly from baclofen should be restarted as soon as possible.