Baclofen, a muscle relaxant prescribed for the alleviation of symptoms of spasticity acts primarily at the spinal level but with high doses, it penetrates the blood-brain barrier and can result in prominent central nervous depression. Baclofen toxicity has been associated with a variety of symptoms ranging from dizziness to deep coma. We report the clinical course, management, and outcome of a case of baclofen overdose who presented in deep coma with loss of brainstem reflexes and a burst suppression (BS) pattern on his electroencephalogram (EEG). In addition, we reviewed the presentation and outcomes of all reported cases of baclofen toxicity with a BS pattern on EEG to evaluate if those cases share a common clinical presentation and for the presence of signs and symptoms that would help the clinician to consider this diagnosis. There appears to be a common clinical picture associated with severe baclofen toxicity consisting of deep coma associated with loss of all brainstem reflexes including pupillary reactivity, frequent association with seizures/myoclonic jerks, and a BS pattern on EEG. The outcome is generally good, and serial EEGs are recommended to document a reversal of the abnormal electrographic features.

中文翻译：

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缺乏脑干反射的昏迷和继发于巴氯芬毒性的脑电图的突然抑制。

Baclofen是一种用于缓解痉挛症状的肌肉放松剂，主要作用于脊柱水平，但高剂量时可穿透血脑屏障，并可导致明显的中枢神经抑制。巴氯芬的毒性与各种症状有关，从头晕到深部昏迷。我们报告一例过量服用巴氯芬的临床过程，管理和结果，该患者在深度昏迷时脑干反射消失，脑电图（EEG）出现猝发抑制（BS）模式。此外，我们通过脑电图上的BS模式回顾了所有报道的巴氯芬毒性反应病例的表现和结果，以评估这些病例是否具有共同的临床表现，以及是否存在有助于临床医生考虑该诊断的体征和症状。似乎存在与严重巴氯芬毒性相关的常见临床表现，包括深昏迷，昏迷与所有脑干反射（包括瞳孔反应性）丧失，癫痫发作/肌阵挛性抽搐频繁相关，以及脑电图上的BS模式有关。结果通常是好的，建议使用连续脑电图记录异常的电描记图特征的逆转。