Journal of Pediatrics Review (Apr 2022)

A Case of Status Epilepticus Due to Topical Lidocaine Toxicity: A Case Report and Review of the Literature

  • Arman Hakemi,
  • Behrang Rezvani Kakhki,
  • Sayyed Majid Sadrzadeh,
  • Seyed Mohammad Mousavi,
  • Elnaz Vafadar Moradi

Journal volume & issue
Vol. 10, no. 1
pp. 57 – 60

Abstract

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Background: Lidocaine hydrochloride is an acetamide derivative that was first introduced by Nils Löfgrene in 1943. It is a local anesthetic agent that is widely used in order to prepare the patient for repairing lacerations in everyday practice. Neurological toxicities have been reported with systemic and topical lidocaine. Methods: An eight-year-old female child was reported with a pure laceration who developed status epilepticus after receiving lidocaine along with ketamine. The patient had no medical history of epilepsy or allergic reaction and had a normal physical and mental development status. She received 200 mg lidocaine without epinephrine and underwent wound repair. The patient also received 60 mg of intramuscular ketamine in order to produce relative sedation. After an hour of wound repair, she developed a tonic-colonic generalized seizure representative of status epilepticus seizure. The convulsions were managed by benzodiazepines, and the patient was discharged without complication Conclusions: Status epilepticus can happen due to lidocaine. Although patients usually recover with no major complications, obeying safety protocols can prevent these events.

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