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Lidocaine and seizures.
1Department of Neurology, University of Miami, Florida, USA.
Therapeutic Drug Monitoring
|June 13, 2000
Summary
Lidocaine can cause seizures at high doses, typically generalized, not focal. A history of partial seizures does not increase the risk of experiencing focal seizures when treated with intravenous lidocaine.
Area of Science:
- Neuroscience
- Pharmacology
Background:
- Lidocaine exhibits concentration-dependent effects on seizure activity.
- High concentrations of lidocaine (above 15 microg/mL) are known to induce seizures in both animals and humans.
- Experimental models show lidocaine-induced seizures consistently initiate in the amygdala.
Purpose of the Study:
- To investigate the discrepancy between experimentally observed focal seizure onset and clinically observed generalized seizures with intravenous lidocaine.
- To determine if a history of partial seizures is a risk factor for developing partial seizures during intravenous lidocaine treatment.
Main Methods:
- Review of existing literature and experimental data on lidocaine-induced seizures.
- Analysis of clinical observations of seizure patterns in patients receiving intravenous lidocaine.
Main Results:
- While experimental models demonstrate focal seizure onset (amygdala), clinical cases of lidocaine-induced seizures are predominantly generalized.
- The expected higher incidence of partial seizures in patients with a history of such seizures was not observed.
Conclusions:
- The clinical presentation of lidocaine-induced seizures differs from experimental models, typically manifesting as generalized seizures.
- A history of partial seizures is not identified as a significant risk factor for precipitating partial seizures during intravenous lidocaine administration.