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Case Reports: Rare disease
Early-onset neonatal seizures: lidocaine toxicity as a rare differential diagnosis to hypoxic ischaemic encephalopathy
  1. Dylan T Stephenson1,
  2. Niranjan Thomas1,2 and
  3. Reka Korbely1
  1. 1Department of Newborn Services, Joan Kirner Women's and Children's Hospital, Western Health, St Albans, Victoria, Australia
  2. 2Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
  1. Correspondence to Dr Dylan T Stephenson; drdylanstephenson{at}gmail.com

Abstract

A term newborn girl presented with apnoea and seizures at approximately 20 min of life following an uneventful vaginal delivery. She required admission to the Neonatal Intensive Care Unit following intubation and was commenced on conventional ventilation. Her mother had received a local lidocaine injection for an episiotomy prior to delivery. Initial investigations confirmed electrographic seizures for which she received an anticonvulsant with successful termination of seizure activity. Investigations for hypoxic injury, intracranial trauma, structural brain abnormalities, metabolic disorders and infection were unremarkable. Her blood lidocaine level was subsequently found to be elevated, confirming lidocaine toxicity as the cause of presentation. She demonstrated clinical improvement with no evidence of complications at time of discharge or on early follow-up.

  • Neonatal and paediatric intensive care
  • Toxicology

https://doi.org/10.1136/bcr-2022-252758

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    Footnotes

    • Contributors DTS was responsible for drafting the manuscript, including revisions. NT was responsible for reviewing the manuscript, providing assistance with editing and providing guidance on the composition and discussion. RK was responsible for reviewing the manuscript and providing guidance on the composition and discussion.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.