Document Detail

Neuropsychiatric side-effects of lidocaine: examples from the treatment of headache and a review.
MedLine Citation:
PMID:  19250287     Owner:  NLM     Status:  MEDLINE    
Lidocaine has been used in treatment of patients with refractory headache. Personal observations of neuropsychiatric toxicity in these patients led us to review our cases and the literature systematically for lidocaine side-effects, especially neuropsychiatric symptoms. In our series of 20 patients, side-effects were observed in all, the most frequent being neuropsychiatric (75%) and cardiological (50%). When reviewing published series on intravenous lidocaine use, reports of side-effects range from 0 to 100%, with neuropsychiatric symptoms being reported in 1.8-100%. Thirty-six case reports of lidocaine-induced psychiatric symptoms were also analysed. Psychiatric symptoms of toxicity were similar in most patients, despite their differing ages, pathologies, co-therapies and lidocaine dosages. In conclusion, lidocaine neuropsychiatric toxicity has a well-recognized stereotypical clinical presentation that is probably unrecognized in headache series. As lidocaine represents an emerging alternative therapy in headache, particularly in short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing, clinicians and patients should be aware of the extent of this problem.
R Gil-Gouveia; P J Goadsby
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-02-24
Journal Detail:
Title:  Cephalalgia : an international journal of headache     Volume:  29     ISSN:  1468-2982     ISO Abbreviation:  Cephalalgia     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-07-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200710     Medline TA:  Cephalalgia     Country:  England    
Other Details:
Languages:  eng     Pagination:  496-508     Citation Subset:  IM    
Headache Group-Department of Neurology, University of California, San Francisco, San Francisco, CA 94115, USA.
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MeSH Terms
Anesthetics, Local / adverse effects*
Bradycardia / chemically induced
Headache / drug therapy*
Hypertension / chemically induced
Lidocaine / adverse effects*
Mental Disorders / chemically induced*
Middle Aged
Nervous System Diseases / chemically induced*
Tachycardia / chemically induced
Reg. No./Substance:
0/Anesthetics, Local; 137-58-6/Lidocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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