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To the Editor:—
The occurrence of major convulsive seizures during treatment of cardiac arrhythmias with intravenous administration of lidocaine hydrochloride (204:201, 1968) is likely to be related to the epileptogenic effect which this drug and the related local anesthetics, procaine and cocaine have on the amygdala nucleus, located just beneath the cortex of the inferior surface of the temporal lobe. Eidelberg, Lesse, and Gault reported in cat and monkey, and we have demonstrated in man (with epilepsy) that small quantities of systemic cocaine are sufficient to provoke high-voltage spike activity sharply limited to the amygdala region. Wagman et al have described similar electrical seizures commencing in the amygdala after the injection of lidocaine systemically in the cat. In man the electrical seizure limited to the amygdala after systemic cocaine is associated with euphoria and increased mental efficiency. The conventional scalp electroencephalogram shows no important change at a time when
Stevens JR. Convulsive Seizures And Lidocaine Treatment. JAMA. 1968;205(2):116-117. doi:10.1001/jama.1968.03140280070028