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Generalized Seizures Following Topical Lidocaine Administration During Circumcision

Establishing Causation

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Abstract

We report a case of neonatal seizures after lidocaine administration for circumcision. A 3-month-old male infant received an overdose as evidenced by toxic lidocaine levels and developed generalized seizures shortly after. Back extrapolation of the serum lidocaine concentration to time zero was used to determine the administered dose. The Naranjo scale was used to determine causation; probable causation was defined. Particular care must be taken to administer an appropriate dose of local anesthetics in infants to avoid life-threatening seizures.

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Acknowledgements

Dr Finkelstein is supported by a fellowship of The Research Training Center, The Hospital for Sick Children, Toronto, ON, Canada. Dr Koren holds the Ivey chair in Molecular Toxicology, University of Western Ontario, London, ON, Canada.

No sources of funding were used to assist in the preparation of this case report. The authors have no conflicts of interest that are directly relevant to the content of this case report.

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Authors and Affiliations

  1. Division of Clinical Pharmacology - Toxicology and Clinical Biochemistry, The Hospital for Sick Children, The Motherisk program, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada

    Massoud Rezvani, Yaron Finkelstein, Zul Verjee, Craig Railton &  Gideon Koren

  2. Ivey Chair in Molecular Toxicology, University of Western Ontario, London, Ontario, Canada

    Gideon Koren

Authors
  1. Massoud Rezvani
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  2. Yaron Finkelstein
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  3. Zul Verjee
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  4. Craig Railton
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  5. Gideon Koren
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Correspondence to Gideon Koren.

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Rezvani, M., Finkelstein, Y., Verjee, Z. et al. Generalized Seizures Following Topical Lidocaine Administration During Circumcision. Pediatr-Drugs 9, 125–127 (2007). https://doi.org/10.2165/00148581-200709020-00006

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  • DOI: https://doi.org/10.2165/00148581-200709020-00006

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