{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T19:27:06Z","timestamp":1783625226281,"version":"3.55.0"},"reference-count":12,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,2,28]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>A term newborn girl presented with apnoea and seizures at approximately 20\u2009min of life following an uneventful vaginal delivery. She required admission to the Neonatal Intensive Care Unit following intubation and was commenced on conventional ventilation. Her mother had received a local lidocaine injection for an episiotomy prior to delivery. Initial investigations confirmed electrographic seizures for which she received an anticonvulsant with successful termination of seizure activity. Investigations for hypoxic injury, intracranial trauma, structural brain abnormalities, metabolic disorders and infection were unremarkable. Her blood lidocaine level was subsequently found to be elevated, confirming lidocaine toxicity as the cause of presentation. She demonstrated clinical improvement with no evidence of complications at time of discharge or on early follow-up.<\/jats:p>","DOI":"10.1136\/bcr-2022-252758","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T11:30:36Z","timestamp":1679571036000},"page":"e252758","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Early-onset neonatal seizures: lidocaine toxicity as a rare differential diagnosis to hypoxic ischaemic encephalopathy"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8048-1750","authenticated-orcid":false,"given":"Dylan T","family":"Stephenson","sequence":"first","affiliation":[{"name":"Department of Newborn Services, Joan Kirner Women's and Children's Hospital, Western Health, St Albans, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1651-3201","authenticated-orcid":false,"given":"Niranjan","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Newborn Services, Joan Kirner Women's and Children's Hospital, Western Health, St Albans, Victoria, Australia"},{"name":"Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reka","family":"Korbely","sequence":"additional","affiliation":[{"name":"Department of Newborn Services, Joan Kirner Women's and Children's Hospital, Western Health, St Albans, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,23]]},"reference":[{"key":"2025082713070412000_16.3.e252758.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.06.094"},{"key":"2025082713070412000_16.3.e252758.2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-320902"},{"key":"2025082713070412000_16.3.e252758.3","first-page":"643","article-title":"Lidocaine intoxication in a newborn following local anesthesia for episiotomy","volume":"64","author":"Kim","year":"1979","journal-title":"Pediatrics"},{"key":"2025082713070412000_16.3.e252758.4","doi-asserted-by":"crossref","first-page":"439","DOI":"10.3233\/NPM-1791","article-title":"Transplacental lidocaine intoxication","volume":"11","author":"Demeulemeester","year":"2018","journal-title":"J Neonatal Perinatal Med"},{"key":"2025082713070412000_16.3.e252758.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.330.7481.34"},{"key":"2025082713070412000_16.3.e252758.6","article-title":"Severe cardiorespiratory and neurologic symptoms in a neonate due to mepivacaine intoxication","volume":"2019","author":"de Groot-van der Mooren","year":"2019","journal-title":"Case Rep Pediatr"},{"key":"2025082713070412000_16.3.e252758.7","first-page":"341","article-title":"Lidocaine and mepivacaine in cord blood","volume":"2","author":"Walson","year":"1982","journal-title":"Pediatr Pharmacol (New York)"},{"key":"2025082713070412000_16.3.e252758.8","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1097\/00000542-196809000-00017","article-title":"Plasma levels of lidocaine (xylocaine) in mother and newborn following obstetrical conduction anesthesia: clinical applications","volume":"29","author":"Shnider","year":"1968","journal-title":"Anesthesiology"},{"key":"2025082713070412000_16.3.e252758.9","first-page":"107","article-title":"Placental transfer of lidocaine and elimination from newborns following obstetrical epidural and pudendal anesthesia","volume":"5","author":"Sakuma","year":"1985","journal-title":"Pediatr Pharmacol (New York)"},{"key":"2025082713070412000_16.3.e252758.10","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.113.051714"},{"key":"2025082713070412000_16.3.e252758.11","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e32834a9394"},{"key":"2025082713070412000_16.3.e252758.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03406.x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-252758","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:07:13Z","timestamp":1756325233000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-252758"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3,23]]},"published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1136\/bcr-2022-252758"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-252758","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}