Acute symptomatic seizures after accidental intrathecal lidocaine administration: A case series

Lidocaine (LA) is a widely used local anaesthetic and analgesic, and a potential therapeutic option for status epilepticus; however, due to its neurotoxicity, it also carries an associated risk of inducing life-threatening seizures and other neurological conditions. The semiology and the treatment of these provoked seizures remain poorly understood.

To better understand the seizure-related behaviour, clinical presentation and electroencephalographic patterns associated to lidocaine-induced seizures.

In this paper we describe three cases of inadvertent intrathecal LA administration for chronic lumbar pain focusing on clinical presentation, laboratory and neuroimaging findings.

Acute symptomatic seizures may represent an adverse reaction to intrathecal lidocaine administration and may present with TNS and alteration of consciousness, leading to status epilepticus. A prompt initiation of antiseizure therapy should be considered to ensure the best outcome.