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Baclofen-induced toxicity in renal disease with neurotoxicity and skin rash

Abstract Baclofen is approved by the Food and Drug Administration for spasticity and is also used off-label for trigeminal neuralgia, cluster headache, and substance abuse dependency. Baclofen is 90% renally excreted and has a variable threshold for toxicity in patients with chronic kidney disease. We present a case of accidental overdose of baclofen in a 58-year-old woman with intractable trigeminal neuralgia. She presented with baclofen neurotoxicity symptoms including confusion and tremors and had a morbilliform rash in the dorsum of both hands. This simultaneous presentation is rare and has never been reported. Her symptoms resolved after hemodialysis treatment.