Annals of Rehabilitation Medicine

"Fever"

Case Reports

Central Hyperthermia Treated With Baclofen for Patient With Pontine Hemorrhage: Hyun Cheol Lee, Jong Moon Kim, Jae Kuk Lim, Yoon Sik Jo, Shin Kyoung Kim; Ann Rehabil Med 2014;38(2):269-272. Published online April 29, 2014; DOI: https://doi.org/10.5535/arm.2014.38.2.269

Abstract
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Central hyperthermia is a very rare disease; however, once it happens, it is associated with a poor prognosis and high mortality for patients with severe brainstem strokes. Following a pontine hemorrhage, a 46-years-old female developed prolonged hyperthermia. Work-ups to the fever gave no significant clues for the origin of fever, and hyperthermia did not respond to any empirical antibiotics or antipyretic agents. The patient's body temperature still fluctuated in a range of 37.5℃ to 39.2℃. Considering the lesion of hemorrhage, we suspected central hyperthermia rather than infectious diseases. We started with baclofen administration at a dose of 30 mg/day. The body temperature changed to a range of 36.6℃ to 38.2℃. We raised the dose of baclofen to 60 mg/day. The patient's body temperature finally dropped to a normal range. Central hyperthermia, caused by failures of thermoregulatory pathways in brainstem, following the pontine hemorrhage rarely occurs. Baclofen can be used to treat suspected central hyperthermia in a patient with pontine hemorrhage.

Citations

Citations to this article as recorded by

Use of Baclofen for Neurogenic Fever in Head Injury Patients: A Case Series of Four Patients
Dharmraj Singh, Mayank Sachan, Priyanka Gautam
Journal of Trauma Intensive Care STIC.2025; 1(2): 32. CrossRef
Postoperative fever following hemispherotomy managed with baclofen: unnoticed treatment
Mohammad Elbaroody, Hossam Eldin Mostafa, Salsabil Abo Al-Azayem, Amani Nawito, Nirmeen A. Kishk, Basim Ayoub
Child's Nervous System.2025;[Epub] CrossRef
Pharmacologic Management of Central Fever: A Review of Evidence for Bromocriptine, Propranolol, and Baclofen
Justin P. Reinert, Zsanett Kormanyos
Journal of Pharmacy Technology.2023; 39(1): 29. CrossRef
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Veronika Kissiová
Neurologie pro praxi.2023; 24(3): 212. CrossRef
Management of Central Hyperthermia in Traumatic Brain Injury Using Baclofen
Ijaz N. Pillai, Gaurav Gomez
Indian Journal of Physical Medicine and Rehabilitation.2023; 33(2): 83. CrossRef
Use of baclofen and propranolol for treatment of neurogenic fever in a patient with pontine hemorrhage: A case report
Saroj Poudel, Rupak Chalise, Manoj Bist, Ashim Regmi, Anup Ghimire, Kishor Khanal
Clinical Case Reports.2023;[Epub] CrossRef
Central Hyperthemia Treated with Bromocriptine in a Patient with Aquaporin 4 Antibody Positive Neuromyelitis Optica Spectrum Disorder
Hayoung Choi, Ryeongtae Kim, Sooyoung Kim, Eunhee Sohn
Journal of Multiple Sclerosis and Neuroimmunology.2023; 14(2): 106. CrossRef
Primary Brainstem Hemorrhage: A Review of Prognostic Factors and Surgical Management
Danyang Chen, Yingxin Tang, Hao Nie, Ping Zhang, Wenzhi Wang, Qiang Dong, Guofeng Wu, Mengzhou Xue, Yuping Tang, Wenjie Liu, Chao Pan, Zhouping Tang
Frontiers in Neurology.2021;[Epub] CrossRef
Central Hyperthermia Due to Intracerebral Hemorrhage Treated with Baclofen: A Case Report
Jiyong Iruon Park, Sung-Kyun Hwang
The Nerve.2021; 7(2): 103. CrossRef
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Lena M. O’Keefe, Gracia Mui
The Neurologist.2020; 25(2): 24. CrossRef
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Wei-Long Ding, Yong-Sheng Xiang, Jian-Cheng Liao, Shi-Yong Wang, Xiang-Yu Wang
Journal of Integrative Neuroscience.2020;[Epub] CrossRef
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Deep Sengupta, Indu Kapoor, Charu Mahajan, Hemanshu Prabhakar
Journal of Clinical Anesthesia.2019; 55: 134. CrossRef
Successful Intrathecal Baclofen Therapy for Intractable Paroxysmal Sympathetic Hyperactivity in Patient with Pontine Hemorrhage: A case report
Hyeon Su Kim, Na Young Kim, Yong Wook Kim
Clinical Neuropharmacology.2018; 41(4): 138. CrossRef
Korean Medical Treatment for Prolonged Central Hyperthermia Following Pontine Hemorrhage: A Case Report
Chan-sol Yi, Song-won Park, Seungcheol Hong, Youngji Kim, Juyeon Song, Jeong-yun Lee, Gil-cho Shin, Dong-jun Choi
The Journal of Internal Korean Medicine.2018; 39(5): 1061. CrossRef
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Frontiers in Psychiatry.2018;[Epub] CrossRef
Central Hyperthermia Treated with Bromocriptine
P. Natteru, P. George, R. Bell, P. Nattanmai, C. R. Newey
Case Reports in Neurological Medicine.2017; 2017: 1. CrossRef

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Iliopsoas Abscess Associated with Lumbar Spondylitis in a Chronic Spinal Cord Injured Patient: A case report.: Park, Young Jin , Kim, Jae Hyung , Park, Jung Hyun , Kim, Hwan Jung; J Korean Acad Rehabil Med 2010;34(4):483-485.

Abstract
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Iliopsoas abscess is relatively uncommon condition that can present with vague clinical features. Its insidious onset and occult characteristics can cause delayed diagnosis, resulting in high mortality and morbidity. We report a 49-year-old male with T7 complete paraplegia (ASIA A) as a result of motor vehicle accident in 1994, presented with fever above 40^oC and myalgia for 15 days and later diagnosed as iliopsoas abscess. Magnetic resonance imaging showed infectious spondylitis, L3, with abscess formation in psoas muscle, bilateral. Intravenous broad spectrum antibiotics treatment, CT-guided percutaneous drainage and surgical management were performed. Febrile episodes are frequent in SCI (spinal cord injured) patients. However, it is sometimes difficult to ascertain the origin of fever in SCI patients, because of altered sensation and lack of localizing physical findings. We suggest that this infectious pathology must keep in mind in SCI patients with fever of unknown origin. (J Korean Acad Rehab Med 2010; 34: 483-485

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Multiple Lumbar Compression Fractures due to Hypopituitarism as a Late Complication of Hemorrhagic Fever with Renal Syndrome: A case report.: You, Seung Don , Kim, Dong Hwan , Huh, Ki Yun , Yoo, Byung Sun , Choi, Seong He; J Korean Acad Rehabil Med 2009;33(5):632-634.

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Male osteoporosis is known to progress slowly and is less severe compared to female osteoporosis, and the incidence of lumbar compression fracture is considerably lower in male population. Hypogonadism which can develop from various causes including hypopituitarism is a common cause for secondary male osteoporosis. Hypopituitarism as a late complication of severe form of hemorrhagic fever with renal syndrome (HFRS) is known to occur occasionally but its clinical symptoms rarely appear. A 75-year-old male patient who had recovered from HFRS 13 years ago was admitted due to severe low back pain. He presented with gradually developed symptoms of hypogonadism and hypothyroidism resulting from hypopituitarism. MRI revealed collapsed pituitary gland and empty sella. This case presents with a male patient with multiple lumbar compression fractures due to severe osteoporosis secondary to hypogonadism, which resulted from hypopituitarism as a late complication of HFRS. (J Korean Acad Rehab Med 2009; 33: 632-634)