Oral Baclofen Toxicity in a Pediatric Patient Managed Without Invasive Intervention: A Case Report and Literature Review

Baclofen is utilized for the management of spasticity associated with neurological disorders such as cerebral palsy, multiple sclerosis, and spinal cord injuries. It acts as an agonist for the gamma-aminobutyric acid (GABA)-B receptor. Although baclofen proves to be effective, it presents a significant risk of toxicity and withdrawal symptoms, particularly among pediatric patients, where pharmacokinetics and clinical presentations may diverge from those observed in adults. Furthermore, baclofen is generally not detected in standard toxicology screening, underscoring the need for heightened clinical awareness. We report a case involving a five-year-old boy who inadvertently received a toxic dose of baclofen. He was admitted to the Pediatric Intensive Care Unit via the pediatric emergency room, exhibiting signs and symptoms of convulsions, drowsiness, and bradycardia. The convulsions were managed with intravenous diazepam, and the child made a full recovery within 24 hours with appropriate supportive care. This case report emphasizes that prompt intervention in the case of baclofen overdose prevented the need for invasive procedures such as mechanical ventilation and hemodialysis. Effective supportive therapy yields favorable outcomes, given that there has been no hypoxic or ischemic injury before receiving medical assistance. This literature review focuses on oral baclofen toxicity, without delving deeply into the topics of intrathecal baclofen toxicity and withdrawal. This case contributes to the expanding literature on pediatric baclofen toxicity and highlights the potential for favorable outcomes with prompt intervention.