{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T15:53:57Z","timestamp":1768924437200,"version":"3.49.0"},"reference-count":12,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,9,24]]},"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:p>Patients with brain death have by definition irreversible and complete loss of brainstem reflexes. Before a definite diagnosis of brain death can be confirmed, all potential confounders must be thoroughly excluded. Baclofen intoxication is a rare cause of brain death mimic characterised by transient deep coma and absence of brainstem reflexes and might be mistaken with brain death. We report the case of a female patient in her 70s who ingested baclofen with suicidal intent and was admitted with a deep coma and loss of all brainstem reflexes and a spontaneous burst-suppression pattern in the electroencephalography which resolved over 10 hours. After a state mimicking brain death for 6\u2009hours, the patient experienced complete recovery. Severe baclofen intoxication can mimic brain death clinically and is associated with temporary pathological electroencephalographic findings. Awareness of this toxidrome is crucial, as appropriate management can lead to full recovery.<\/jats:p>","DOI":"10.1136\/bcr-2023-257391","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T11:51:07Z","timestamp":1707306667000},"page":"e257391","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Neurological evolution of severe baclofen intoxication: from brain death mimic to recovered brain function"],"prefix":"10.1136","volume":"16","author":[{"given":"Sebastian","family":"Berger","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Department of Acute Medicine, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Kuster","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Department of Acute Medicine, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raoul","family":"Sutter","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Department of Acute Medicine, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Urs","family":"Fisch","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Neurology, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,10,6]]},"reference":[{"key":"2025082801285427000_16.10.e257391.1","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.jcrc.2019.06.030","article-title":"What to exclude when brain death is suspected","volume":"53","author":"Grzonka","year":"2019","journal-title":"J Crit Care"},{"key":"2025082801285427000_16.10.e257391.2","doi-asserted-by":"publisher","DOI":"10.1097\/00002826-199202000-00008"},{"key":"2025082801285427000_16.10.e257391.3","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1016\/j.jemermed.2021.11.007","article-title":"A severe baclofen intoxication mimicking post-hypoxic encephalopathy: wait and see!","volume":"62","author":"Muntinga","year":"2022","journal-title":"J Emerg Med"},{"key":"2025082801285427000_16.10.e257391.4","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2011.654209"},{"key":"2025082801285427000_16.10.e257391.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0013-4694(98)00085-6"},{"key":"2025082801285427000_16.10.e257391.6","doi-asserted-by":"crossref","unstructured":"Sutter R , Pang T , Kaplan PW . Electroencephalography in metabolic disorders, Intoxications, and epileptic Encephalopathies. In: Schomer DL , Lopez da FH , eds. Niedermeyer\u2019s electroencephalography basic principles, clinical applications, and related fields. 7th edn. edn. Oxford University Press, 2018: 433\u201366.","DOI":"10.1093\/med\/9780190228484.003.0017"},{"key":"2025082801285427000_16.10.e257391.7","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410170202"},{"key":"2025082801285427000_16.10.e257391.8","doi-asserted-by":"crossref","unstructured":"Romito JW , Turner ER , Rosener JA , et al . Baclofen therapeutics, toxicity, and withdrawal: a narrative review. SAGE Open Med 2021;9. doi:10.1177\/20503121211022197","DOI":"10.1177\/20503121211022197"},{"key":"2025082801285427000_16.10.e257391.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-6723.2006.00805.x"},{"key":"2025082801285427000_16.10.e257391.10","doi-asserted-by":"crossref","first-page":"404","DOI":"10.3389\/fneur.2020.00404","article-title":"Coma with absent brainstem reflexes and a burst suppression on EEG secondary to baclofen toxicity","volume":"11","author":"Farhat","year":"2020","journal-title":"Front Neurol"},{"key":"2025082801285427000_16.10.e257391.11","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/ags076"},{"key":"2025082801285427000_16.10.e257391.12","doi-asserted-by":"publisher","DOI":"10.1007\/s001340051330"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-257391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:29:05Z","timestamp":1756369745000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-257391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":12,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10,6]]},"published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1136\/bcr-2023-257391"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-257391","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]}}}