Dose-dependent relapse of hiatus hernia after administration of intrathecal baclofen treatment—a rare complication

Introduction: Intrathecal baclofen treatment (ITB) is widely used in children with cerebral palsy. Although this treatment effectively reduces spasticity, diverse side effects are reported. Case report: We report about a boy with severe asphyxia-induced encephalopathy with bilateral cerebral palsy. After starting the intrathecal baclofen treatment, he episodically showed symptoms of severe gastroesophageal reflux with pale skin color, vomiting, massive drooling, acid regurgitation, and reduced well-being. An open ventral semifundoplication was done some years ago to treat a gastroesophageal reflux. These symptomatic episodes occurred strongly dose-dependent and were not observed during the short test procedure. Conclusion: For the first time, a strong dose-dependent treatment with ITB was documented as a cause for the above episodes and relapsing re-herniation