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Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
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Related Experiment Video

Updated: Jun 30, 2025

Author Spotlight: Genetic Profiling for Fluorouracil Response in Gastric Cancer
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Author Spotlight: Genetic Profiling for Fluorouracil Response in Gastric Cancer

Published on: May 10, 2024

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Focal Neurotoxicity Associated With Topical 5-Fluorouracil.

Ryan M Garcia1, Maura Mobilia1, Jack B Newcomer1

  • 1Dermatology, University of Kentucky College of Medicine, Lexington, USA.

Cureus
|March 19, 2024
PubMed
Summary
This summary is machine-generated.

Topical 5-Fluorouracil (5-FU) cream, used for skin conditions, may rarely cause neurotoxicity. A case report details supraorbital neuralgia following 5-FU treatment, highlighting potential risks for patients, especially those with DPD deficiency.

Keywords:
5 fluorouracil5 fluorouracil neurotoxicityactinic keratosistopical chemotherapytoxic neuropathy

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Area of Science:

  • Dermatology and Neurology
  • Pharmacology

Background:

  • Topical 5-Fluorouracil (5-FU) is a chemotherapy agent for skin cancers like actinic keratoses.
  • Systemic 5-FU and capecitabine are known to cause neuropathy.
  • Neurotoxicity from topical 5-FU has not been previously documented.

Observation:

  • An 83-year-old male developed focal neurotoxicity on his scalp after applying 5-FU cream.
  • Symptoms included paralysis of the frontalis muscle, sensory loss, pain, and paresthesias.
  • Neurologic deficits persisted for four months post-treatment.

Findings:

  • The patient was diagnosed with supraorbital neuralgia.
  • The localized symptoms and temporal association suggest 5-FU as the cause.
  • Genetic deficiency in dihydropyrimidine dehydrogenase (DPD) may increase risk by impairing 5-FU metabolism.

Implications:

  • Clinicians should recognize the potential for topical 5-FU to induce neurotoxic effects.
  • Patient counseling regarding potential neurologic adverse events is crucial.
  • Topical 5-FU neurotoxicity should be considered in patients presenting with relevant neurologic deficits.