Status epilepticus following local anesthesia in a previously healthy adult

Abstract

BackgroundLocal anesthesia could result in lethal complications if injected in highly vascularized area. Dentist should take care to avoid such complications.Case presentationWe present a case of 15 year old girl with a coma following convulsive status epilepticus which developed after inferior alveolar nerve blockade by a dentist. The patient was admitted to the intensive care unit ICU and recovered within several days.ConclusionThis case is reported to tell both of dentists and medical staff that although it is uncommon, such complications of local anesthesia should be in mind to be avoided and managed promptly if happened.

Electrocorticographic description of the effects of anticonvulsant drugs used to treat lidocaine‐induced seizures

“…Despite the existence of many reports of seizures induced by LA, little is known about this phenomenon. In the present study, LA was shown to be capable of inducing tonic–clonic seizures in rats which are consistent with the seizures described in a number of published case reports (Alsukhni et al., 2016; Aminiahidashti et al., 2015; Nicholas & Thornton, 2016). Records of brain activity during LA poisoning and responses to anticonvulsants are rarely found in the literature.…”

“…There is increasing evidence, with many case reports, of seizures induced by LA (Rahimi et al., 2018). This may occur even when administered by healthcare professionals (Alsukhni et al., 2016; Nicholas & Thornton, 2016), although major contributors include the indiscriminate use of local anesthetics and over‐the‐counter purchases (Aminiahidashti et al., 2015; Hoda et al., 2016), and even suicide attempts (Rahimi et al., 2018; Szadkowski et al., 2017).…”

Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study

“…Combining neoadjuvant chemo-and radiotherapy has proven to be effective to downstage the primary tumour and it leads in about 20% of the patients to complete disappearance of the tumour and tumour positive lymph nodes, a pathological complete response (pCR), which is associated with favourable longterm outcomes compared to those without complete response . 5,6 Since the first introduction of watch and wait (W&W) for rectal cancer patients with a clinical complete response (cCR) after neoadjuvant chemoradiotherapy by Habr-Gama, 7 multiple cohort series are now available in which surgery has been omitted. [8][9][10][11] It is known that the diagnosis of a cCR based on the results of conventional imaging modalities does not perfectly correspond to a true CR, as local regrowth rates within 2 years of follow up range from 7 to 33%.…”

Local Anesthetic-Induced Central Nervous System Toxicity during Interscalene Brachial Plexus Block: A Case Series Study of Three Patients

“…Of note, test aspirations fail to identify an intravascular needle placement in up to 2% of patients [ 54 ]. Additionally, even a small amount of local anesthetic injected unintentionally within an extracranial artery supplying the brain can result in concentrations sufficient to induce CNS toxicity [ 55 ]. Our conclusion is further corroborated by MRI scans, showing abnormal MRI signal intensities in the corresponding cerebral vascular territories on the side of ISB in two patients (patients 2 and 3), strongly supporting the hypothesis of an arterial blood flow-mediated local anesthetic CNS toxicity.…”

“…Taking this into account, it is not entirely clear to what extent apoptotic and other cellular mechanisms seen in in vitro studies effectively contribute to clinical manifestation of local anesthetic neurotoxicity. Nevertheless, several clinical case reports and observational studies have shown that lidocaine and ropivacaine can induce a broad variation of severe neurotoxic side effects after intravascular injection or repeated use [ 29 , 30 , 55 , 64 , 65 , 66 , 67 ]. One of these neurotoxic side effects is a change of cerebral electrical activity observed on EEG.…”