A case described severe autonomic instability after an infected intrathecal system was removed. Symptomatic medicines including clonazepam did not adequately control the evolving presentation.
The patient had longstanding cervical spinal-cord injury and successful intrathecal baclofen treatment. Infection required reduction of the intrathecal medicine and pump removal.
Severe autonomic dysreflexia followed despite clonazepam, clonidine, and urapidil. Reintroduction of intrathecal baclofen through a temporary external catheter was followed by control of dysreflexia and spasticity.
The case involved loss of a long-established intrathecal treatment and a condition with several possible triggers. It does not establish that clonazepam is generally ineffective for spasticity or identify a universal rescue regimen.
The report supports reconstructing delivery-system changes alongside medicine administration. A sedative on the chart does not establish that the underlying withdrawal or autonomic process was treated. Forensic interpretation should preserve pump function, infection, taper details, autonomic observations, and response to restored delivery rather than treating all agitation or hypertension as one drug effect.
Original analysis of the supplied journal article, identified as PMC8288123.