Systemic naloxone infusion may trigger spasticity in patients with spinal cord injury: Case series

Nancy Brackett, Emad Ibrahim, Andrei Krassioukov, Charles M Lynne

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background/Objective: Three patients with spinal cord injury (SCI) and 3 able-bodied (AB) patients were infused with naloxone during a study to examine their neuroendocrine function. An unanticipated side effect occurred during the naloxone infusion. All 3 patients with SCI, but none of the AB patients, experienced profoundly increased spasticity during the naloxone infusion. Our report describes this side effect, which has potential implications for the clinical treatment or scientific evaluation of individuals with SCI. Methods: All patients were in good general health and medication free for 11 days or longer before the study. Each patient was placed on a 30-hour protocol to analyze pulsatile release of gonadotropins. Physiologic saline was intravenously infused on day 1 to serve as a control period for naloxone infusion on day 2. Results: AB patients experienced no muscle spasm activity or any other side effects at any time during the study. In contrast, all 3 patients with SCI experienced a profoundly increased frequency and duration of spasticity in muscles innervated by the nerve roots caudal to their level of injury. In all 3 patients with SCI, spasticity increased only during the period of naloxone infusion. Within 1 hour of stopping naloxone, spasticity returned to baseline levels. Conclusions: Naloxone infusion produced a differential effect on the muscle activity of men with SCI compared to AB men with intact spinal circuits. Consistent with previous studies, the results of this study indicate a relationship between opioid neuromodulation and spasticity after SCI.

Original languageEnglish
Pages (from-to)272-275
Number of pages4
JournalJournal of Spinal Cord Medicine
Volume30
Issue number3
StatePublished - Jul 27 2007

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Naloxone
Spinal Cord Injuries
Muscle Spasticity
Spasm
Gonadotropins
Opioid Analgesics
Muscles
Health
Wounds and Injuries

Keywords

  • Endorphins
  • Naloxone
  • Opioid
  • Spasticity
  • Spinal cord injuries

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Systemic naloxone infusion may trigger spasticity in patients with spinal cord injury : Case series. / Brackett, Nancy; Ibrahim, Emad; Krassioukov, Andrei; Lynne, Charles M.

In: Journal of Spinal Cord Medicine, Vol. 30, No. 3, 27.07.2007, p. 272-275.

Research output: Contribution to journalArticle

Brackett, Nancy ; Ibrahim, Emad ; Krassioukov, Andrei ; Lynne, Charles M. / Systemic naloxone infusion may trigger spasticity in patients with spinal cord injury : Case series. In: Journal of Spinal Cord Medicine. 2007 ; Vol. 30, No. 3. pp. 272-275.
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