Transitory ataxia related to topically administered lidocaine

Ann Pharmacother. 2004 May;38(5):828-30. doi: 10.1345/aph.1D494. Epub 2004 Mar 23.

Abstract

Objective: To report 2 cases of transitory cerebellar ataxia related to lidocaine administered topically for endoscopy. case summaries: Two patients developed transitory cerebellar ataxia a few minutes after local anesthesia using lidocaine 10% spray and lidocaine 2% orally for a bronchoscopy and transesophageal echocardiography. This effect completely disappeared in 3-5 hours. In neither case was an alternate etiology of cerebellar ataxia identified. The second patient had previously experienced a similar reaction to lidocaine.

Discussion: Several central neurologic effects of lidocaine have been reported, but until now, only few cases of cerebellar ataxia. In these 2 cases, the Naranjo probability scale indicated that a probable and a highly probable relationship existed between lidocaine administration and the transitory cerebellar ataxia.

Conclusions: Cerebellar ataxia may occur after local anesthesia with lidocaine; therefore, care must be taken to avoid overdose, even when administered topically.

Publication types

  • Case Reports

MeSH terms

  • Administration, Topical
  • Aged
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / adverse effects*
  • Cerebellar Ataxia / chemically induced*
  • Female
  • Humans
  • Lidocaine / administration & dosage
  • Lidocaine / adverse effects*
  • Male
  • Middle Aged

Substances

  • Anesthetics, Local
  • Lidocaine