title: Lidocaine toxicity misinterpreted as a stroke.
abstract: For more than 50 years lidocaine has been used to treat ventricular arrhythmias. Neurologic dysfunction, manifested as a stroke, occurred acutely in an 87-year-old woman after she had been administered repeated doses of lidocaine, a lidocaine infusion, then an intravenous amiodarone infusion for ventricular tachycardia. This was ultimately diagnosed as lidocaine toxicity with a serum lidocaine level of 7.9 mg/L (1.5-6.0 mg/L). We discuss lidocaine toxicity and risk factors leading to its development, which include particularly hepatic dysfunction, cardiac dysfunction, advanced age and other drug administration.
authors.affiliation: University of Connecticut School of Medicine, Division of Emergency Medicine, Hartford, CT.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bursell
authors.forename: Richard M
authors.initials: RM
authors.lastname: Ratzan
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Smally