[Treatment of status epilepticus with intravenous lidocaine (Xylocaine)]

Abstract

A case history of a 19-year old epileptic woman with diffuse encephalopathy of unknown aetiology and frequent attacks of status, epilepticus, whose last episode of the status epilepticus was successfully treated with intravenous lidocaine, after several first-line antiepileptic drugs failed to control, it, is presented. Although highly effective in treating refractory status epilepticus this treatment received little attention in clinical practice. We observed no un desired side effects of such treatment. The authors shortly reviewed current knowledge about several widely used treatment protocols. Some specific pharmacokinetic and pharmacodynamic properties of lidocaine during convulsions were also mentioned. A warning was drawn to toxic fide effects of lidocaine which were precipitated by increasing brain-blood pH gradient during convulsions, which in high doses included seizures caused by lidocaine per se. The effects of high dose lidocaine on the latencies and the amplitudes of the BAER and possible ways for mechanism of drug action were also reviewed.