Background: Baclofen withdrawal is a potentially life-threatening syndrome that can present with
acute neuropsychiatric and autonomic disturbances, particularly in older adults. Prompt recognition
is essential, as symptoms may mimic other causes of encephalopathy or delirium. This case report
describes a 78-year-old woman who developed acute altered mental status due to baclofen withdrawal,
highlighting diagnostic challenges and management strategies.
Case Summary: A 78-year-old woman with a history of chronic baclofen use for spasticity presented
with acute confusion, agitation, and autonomic instability after abrupt discontinuation of baclofen.
Initial evaluation revealed no infectious, metabolic, or tumoral etiology. The diagnosis of baclofen
withdrawal was established based on clinical history and exclusion of alternative causes. Reinitiating
baclofen and supportive care led to the rapid resolution of symptoms.
Conclusion: Baclofen withdrawal should be considered in the differential diagnosis of acute
encephalopathy, especially in elderly patients with a history of baclofen use. Early recognition and
prompt reintroduction of baclofen are critical for favorable outcomes.
