Intravenous lidocaine for status epilepticus during childhood

Abstract

The clinical efficacy of lidocaine for convulsive status epilepticus in 53 convulsive episodes was examined in 37 children (17 males, 20 females). Mean age of patients receiving lidocaine was 3 years 7 months (SD 3y 5mo). Lidocaine administration achieved control of status epilepticus in 19 of 53 convulsive episodes (35.8%). Seizures ceased within 5 minutes of lidocaine administration in all 19 patients who were responsive to the drug. Regarding aetiology of status epilepticus and types of seizures, there was no statistical difference in effectiveness. Mild decrease of oxygen saturation, monitored by pulse oximetry, was observed in one patient, which improved by oxygenation using a mask. Lidocaine is a useful anticonvulsive agent; however, the response rate to lidocaine appears to be quite low, as less than half of the seizures were effectively controlled by lidocaine. Favourable properties of the drug include prompt responses, less alteration of consciousness, and fewer adverse effects, including less respiratory depression.

Lidocaine for Status Epilepticus in Pediatrics

“…Of the 21 articles included in the review, 20 were original studies, [15][16][17][18][19][20][21][22][23][24][25][26][28][29][30][31][32][33][34][35] with one companion abstract publication identified. 27 The companion abstract was included for completeness 27 and was not included for the rest of the review to avoid duplication of patient data.…”

“…There were 15 original retrospective studies 15,16,18,20,21,[23][24][25][26]28,30,[32][33][34][35] and five prospective studies. 17,19,22,29,31 Within the retrospective studies, 12 were retrospective case series 15,16,18,20,21,24,26,28,30,32,34,35 and the remaining three were retrospective case reports. 23,25,33 All studies were based in single centers.…”

“…15,16,18,20,21,[23][24][25][26]28,30,[32][33][34][35] Within these 15 studies, one used bolus dosing of lidocaine in isolation, 15 with a dose of 100 mg intravenously once.…”

“…28 Six studies used bolus dosing of lidocaine, followed by continuous infusions. 16,20,21,24,25,32 The initial bolus ranged from 0.91 mg/kg to 4 mg/kg intravenously, typically given over 20 minutes (when documented). The infusion rates ranged up to 2 to 6 mg/kg/hour.…”

“…The duration of the lidocaine infusions in this group of studies varied from 1 to 36 days, with three manuscripts failing to document duration of therapy. 20,24,32 Finally, four studies failed to document the details of lidocaine dosing and administration. 18,30,33,35 Lidocaine treatment characteristics can be seen in Table 2.…”