title: Generalized seizures following topical lidocaine administration during circumcision: establishing causation.
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.
authors.affiliation: Division of Clinical Pharmacology - Toxicology and Clinical Biochemistry, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Massoud
authors.initials: M
authors.lastname: Rezvani
authors.forename: Yaron
authors.initials: Y
authors.lastname: Finkelstein
authors.forename: Zul
authors.initials: Z
authors.lastname: Verjee
authors.forename: Craig
authors.initials: C
authors.lastname: Railton
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
mesh_terms: D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002944:Circumcision, Male; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D012640:Seizures / Q000139:chemically induced*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine