ISSN 1941-5923


Welcome to the American Journal of Case Reports

Clinical case reports are an invaluable first-hand source of evidence in medicine and a tool most often used in practice to exchange information and generate a more expanded search for evidence. In addition to the “evidence of what happened”, single or multiple cases are an important basis for further and more advanced research on diagnosis,  treatment effectiveness, causes and outcomes of disease. However limited their... read more

Published: 2015-04-20

Encephalopathy and Hypotonia due to Baclofen Toxicity in a Patient with End-Stage Renal Disease

Mohsin Ijaz, Hassan Tariq, Muhammad Kashif, Jose Gomez Marquez

(Division of Pulmonary and Critical Care Medicine, Department of Medicine, Bronx Lebanon Hospital Center, Bronx, NY, USA)

Am J Case Rep 2015; 16:232-235

DOI: 10.12659/AJCR.893222

Background: Baclofen is a centrally acting gamma-aminobutyric acid agonist used for the symptomatic relief of skeletal muscle spasm and spasticity in traumatic spinal cord lesions, multiple sclerosis, cerebral palsy, and stroke. It is also used in the treatment of chronic hiccups and cocaine abuse. Baclofen-induced central nervous system depression is rare at the usual therapeutic doses. However, patients with impaired renal function are at a higher risk of developing baclofen toxicity, even at a lower dose.
Case Report: A 57-year-old woman with end-stage renal disease on hemodialysis was admitted to our emergency department with progressive confusion and a generalized decrease in muscular tone. There was no obvious metabolic or infectious etiology that could have explained her condition. A comprehensive laboratory and imaging workup was negative. A review of her medication showed that she had recently been prescribed baclofen for muscular spasm. She was diagnosed with baclofen toxicity and was treated with emergent hemodialysis, which improved her mental status and her decreased muscle tone. Repeated sessions of hemodialysis administered on her second and third days of admission ultimately produced sustained clinical improvement and a complete return to her baseline mental status. She was subsequently discharged home with instructions to stay off baclofen.
Conclusions: Baclofen toxicity is an under-diagnosed condition, especially in patients with renal dysfunction. Physicians should consider baclofen toxicity in patients with suboptimal kidney function on baclofen who present with altered mental status. Emergent hemodialysis and intensive care u... read more

Keywords: baclofen, Consciousness Disorders, Kidney Failure, Chronic, Muscle Hypotonia, Spasm

Published: 2015-04-18

Jugulotympanic Paraganglioma: A Rare Cause of Vertigo

Asad Jehangir, Ranjan Pathak, Bilal Shaikh, Ahmed Salman, Shoaib Bilal Fareedy, Anam Qureshi, Qasim Jehangir, Richard Alweis

Am J Case Rep 2015; 16:228-231

DOI: 10.12659/AJCR.893366

Published: 2015-04-16

Prolonged Response of Meningeal Carcinomatosis from Non-small Cell Lung Cancer to Salvage Intrathecal Eto...

Min Jae Park

Am J Case Rep 2015; 16:224-227

DOI: 10.12659/AJCR.894061