Pharyngeal spasticity due to dantrolene

J Clin Pharm Ther. 2014 Aug;39(4):449-51. doi: 10.1111/jcpt.12161. Epub 2014 Apr 12.

Abstract

What is known and objective: Dantrolene can be combined with baclofen to better treat spasticity, but may cause muscular weakness and dysphagia. We instead describe a pharyngeal spasm due to dantrolene.

Case summary: A 12-year-old male received dantrolene 3 mg/kg/day in adjunct to baclofen 2 mg/kg/day, to improve spasticity. After 5 days of full-dose dantrolene, his dysphagia worsened and he developed pharyngeal spasm. Dantrolene was suspected for an adverse reaction and removed. The patient subsequently improved.

What is new and conclusion: Causality analysis determined a probable relationship between dantrolene and pharyngeal spasm. This may be due to direct muscle contraction by dantrolene, an effect seen previously in vitro.

Keywords: adverse effect; paediatrics; traumatic brain injury.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Baclofen / administration & dosage
  • Child
  • Dantrolene / administration & dosage
  • Dantrolene / adverse effects*
  • Deglutition Disorders / chemically induced
  • Drug Therapy, Combination
  • Humans
  • Male
  • Muscle Contraction / drug effects
  • Muscle Relaxants, Central / administration & dosage
  • Muscle Relaxants, Central / adverse effects*
  • Muscle Spasticity / chemically induced*
  • Muscle Spasticity / physiopathology
  • Pharyngeal Diseases / chemically induced*
  • Pharyngeal Diseases / physiopathology

Substances

  • Muscle Relaxants, Central
  • Dantrolene
  • Baclofen