{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:52:32Z","timestamp":1788288752514,"version":"build-2803163510"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T00:00:00Z","timestamp":1620518400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T00:00:00Z","timestamp":1620518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Spasticity and neuropathic pain are common in patients after spinal cord injury and negatively affect patients\u2019 quality of life. Gabapentin and baclofen are frequently used to treat these conditions. We present a flumazenil-reversed gabapentin-induced coma case, which, to our knowledge, is the second one described in scientific literature.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 70-year-old Caucasian man was admitted to our neurorehabilitation ward following a fall with cervical trauma that resulted in immediate tetraplegia. During his stay, he suffered from lower limb pain, both neuropathic and due to severe spasticity. Gradual baclofen and gabapentin administration was prescribed, with reduction in both pain and spasticity. One morning, the patient was found unresponsive, with a Glasgow Coma Score of 3. Head computerized tomography, electrocardiogram, electroencephalogram, vital signs, blood tests, breathing, and blood oxygenation were normal. Renal and liver failure were ruled out. Intravenous 0.25\u00a0mg of flumazenil (Anexate) was administered, resulting in complete neurocognitive recovery with a Glasgow Coma Score of 15.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion and conclusions<\/jats:title>\n                <jats:p>This case report highlights the importance of the individual response to certain pharmacological agents and suggests that further studies need to be conducted both on flumazenil and gabapentin pharmacodynamics to better understand their molecular\u2013receptor activity, and on possible multiple flumazenil mechanisms of action, beyond its classical strict benzodiazepine antagonist action.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-02816-3","type":"journal-article","created":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T23:04:58Z","timestamp":1620515098000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Flumazenil therapy for a gabapentin-induced coma: a case report"],"prefix":"10.1186","volume":"15","author":[{"given":"M.","family":"Masciullo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Pichiorri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Scivoletto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Foti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Molinari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,9]]},"reference":[{"issue":"12","key":"2816_CR1","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1038\/sc.2017.70","volume":"55","author":"NB Finnerup","year":"2017","unstructured":"Finnerup NB. Neuropathic pain and spasticity: intricate consequences of spinal cord injury. Spinal Cord. 2017;55(12):1046\u201350. https:\/\/doi.org\/10.1038\/sc.2017.70.","journal-title":"Spinal Cord"},{"issue":"6","key":"2816_CR2","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1038\/sj.sc.3101300","volume":"40","author":"TP To","year":"2002","unstructured":"To TP, Lim TC, Hill ST, et\u00a0al. Gabapentin for neuropathic pain following spinal cord injury. Spinal Cord. 2002;40(6):282\u20135. https:\/\/doi.org\/10.1038\/sj.sc.3101300.","journal-title":"Spinal Cord"},{"key":"2816_CR3","doi-asserted-by":"publisher","unstructured":"Tai Q, Kirshblum S, Chen B, Millis S, Johnston M, DeLisa JA. Gabapentin in the treatment of neuropathic pain after spinal cord injury: a prospective, randomized, double-blind, crossover trial. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Authors do not have any competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"242"}}