title: Lidocaine for Status Epilepticus in Pediatrics.
abstract: BACKGROUND
  Our goal was to perform a systematic review of the literature on the use of intravenous lidocaine in pediatrics for status epilepticus (SE) and refractory status epilepticus (RSE) to determine its impact on seizure control.
  
  
  METHODS
  All articles from MEDLINE, BIOSIS, EMBASE, Global Health, HealthStar, Scopus, Cochrane Library, the International Clinical Trials Registry Platform (inception to November 2014), and gray literature were searched. The strength of evidence was adjudicated using both the Oxford and Grading of Recommendations Assessment, Development, and Evaluation methodologies by two independent reviewers.
  
  
  RESULTS
  Overall, 20 original studies were identified, with 19 manuscripts and one meeting abstract. Two hundred and thirty-five pediatric patients were treated for 252 episodes of SE/RSE. Patients had varying numbers of antiepileptic drugs (two to eight) on board before lidocaine therapy. During 20 of the 252 (7.9%) episodes of SE/RSE, phenytoin was on board. The dose regimen of lidocaine varied, with some using bolus dosing alone; others used a combination of bolus and infusion therapy. Overall, 60.0% of seizures responded to lidocaine, with complete cessation and greater than 50% reduction seen in 57.6% and 12.3%, respectively. Patient outcomes were sparingly reported.
  
  
  CONCLUSIONS
  There currently exists Oxford level 2b, Grading of Recommendations Assessment Development, and Evaluation C evidence to support the consideration of lidocaine for SE and RSE in the pediatric population. Further prospective studies of lidocaine administration in this setting are warranted.
authors: 1Section of Neurosurgery,Department of Surgery,University of Manitoba,Winnipeg,Canada.
authors: Frederick A
authors: FA
authors: Zeiler
authors: 2Misericordia Health Center,Winnipeg,MB,Canada.
authors: Kaitlin J
authors: KJ
authors: Zeiler
authors: 3Section of Neurocritical Care,Montreal Neurological Institute,McGill,Montreal,Canada.
authors: Jeanne
authors: J
authors: Teitelbaum
authors: 5Section of Critical Care Medicine,Department of Medicine,University of Manitoba,Winnipeg,Canada.
authors: Lawrence M
authors: LM
authors: Gillman
authors: 1Section of Neurosurgery,Department of Surgery,University of Manitoba,Winnipeg,Canada.
authors: Michael
authors: M
authors: West
authors: 1Section of Neurosurgery,Department of Surgery,University of Manitoba,Winnipeg,Canada.
authors: Colin J
authors: CJ
authors: Kazina
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D010372:Pediatrics; D010672:Phenytoin / Q000627:therapeutic use*; D011446:Prospective Studies; D012640:Seizures / Q000188:drug therapy*; D013226:Status Epilepticus / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin; D008012:Lidocaine
keywords: clinical pharmacology; epilepsy; epilepsy - pediatric; neurocritical care; neurology - neonatal; neurology - pediatric; pediatric neurology; pediatrics; seizures; status epilepticus