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Disruption of Frontal Lobe Neural Synchrony During Cognitive Control by Alcohol Intoxication

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Transplacental lidocaine intoxication.

V Demeulemeester¹, H Van Hautem², F Cools¹

¹Neonatology, UZ Brussel, Vrije Universiteit Brussel (VUB), Jette, Belgium.

Journal of Neonatal-Perinatal Medicine

|August 29, 2018

Summary

Neonatal seizures can rarely be caused by toxin exposure. A newborn experienced seizures due to transplacental maternal lidocaine exposure from a perineal nerve block.

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Area of Science:

Neonatology
Toxicology
Pharmacology

Background:

Neonatal seizures are common, often linked to perinatal asphyxia.
Toxin exposure is an infrequent but critical cause of neonatal seizures.
Maternal anesthesia administration can pose risks to the neonate.

Observation:

A newborn presented with apnea, hypotonia, mydriasis, tongue fasciculation, and tonic seizures shortly after birth.
Clinical presentation mimicked hypoxic ischemic encephalopathy but lacked supporting evidence.
Normal brain imaging ruled out structural abnormalities.

Findings:

Toxicology screening revealed elevated lidocaine levels in the infant's blood.
Cord blood analysis confirmed transplacental transfer of lidocaine.
Maternal perineal nerve block with lidocaine was identified as the probable source of intoxication.

Implications:

Local anesthetic administration during labor requires careful consideration of neonatal risks.
Toxicology screening is crucial for diagnosing unexplained neonatal seizures and collapse.
This case highlights the importance of maternal medication history in neonatal care.