psd-502 and Seizures

A eutectic mixture of lidocaine and prilocaine (EMLA) is used topically to provide local anesthesia for a variety of painful superficial procedures. Although the side effects of EMLA are usually mild and transient local reactions, potentially life-threatening complications can occur. We report a case of generalized seizures and methemoglobinemia after topical application of EMLA for curettage of molluscum contagiosum lesions in a 3.5-year-old girl with atopic dermatitis.

Topics: Administration, Topical; Anesthetics, Local; Child, Preschool; Dermatitis, Atopic; Female; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Methemoglobinemia; Molluscum Contagiosum; Prilocaine; Seizures

Topical anesthetics are commonly used in many health care settings and for many clinical conditions. However, there are a number of potential adverse effects associated with their use. Their widespread administration can convey a false sense of security and failure to appreciate possible complications. We present the case of an infant with extensive vascular malformations treated with EMLA cream who developed seizures and methemoglobinemia from lidocaine and prilocaine toxicity. We describe the pathophysiology of these morbidities, the use of pulse oximetry in this setting, and the clinical presentation and treatment of methemoglobinemia.

Topics: Administration, Topical; Anesthetics, Local; Diagnosis, Differential; Female; Humans; Infant; Lidocaine; Lidocaine, Prilocaine Drug Combination; Methemoglobinemia; Port-Wine Stain; Prilocaine; Seizures

Topics: Anesthetics, Combined; Anesthetics, Local; Child, Preschool; Eczema; Female; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Methemoglobinemia; Prilocaine; Seizures