Lidocaine safe, effective for children with cluster seizures
Lidocaine prolongs seizure remission without resulting in harmful side effects in children with cluster seizures, a recent study has found.
The study included four children (median age, 7 years; two boys) who received continuous intravenous infusion of 2% lidocaine for drug-resistant cluster seizures. Medication was first administered at a dose of 1 mg/kg/hour, which was then increased to 2–4 mg/kg/hour. Treatment continued for 5–10 days.
Complete seizure cessation was initially achieved after lidocaine infusion, though recurrence was observed after a few months. As a result, all patients had to take at least two antiepileptic drugs. Remission persisted for a mean of 2.4 months.
Notably, seizure frequency was reduced by 80–100 percent, which was sustained over the mean follow-up duration of 7.5 months. Moreover, no additional cases of cluster seizures occurred. All participants tolerated lidocaine medication well and did not experience treatment-related adverse events.
According to the authors, the present findings, together with the fact that seizure remission and reduction persisted even after lidocaine withdrawal, suggest that the drug may have a long-term antiepileptic effect. However, the risk of adverse events remains present, and medication should be immediately discontinued as soon as arrhythmia or other such side effects arise.
“Clinicians should be aware of possible adverse effects and necessity of sustained cardiological surveillance during the treatment,” they said, emphasizing the requirement for further studies to confirm the long-term efficacy and safety of lidocaine in these patients.