Case Study of Fatal Stroke Following Intranasal Lidocaine.

A 39-year-old man presented with new onset right hemiparesis and aphasia within an hour of using approximately 120 mL lidocaine 4% topical solution intranasally. Lidocaine had been prescribed over a 3-week period for pain due to multiple debridements of the nasal septum. A total of 650 mL of 4% lidocaine (26 g) had been dispensed to the patient during this time.

Albumin utilization in cardiac surgery after transition to hydroxyethyl starch 130/0.4.

Objective: Evaluate the impact of replacing hydroxyethyl starch (HES) 670/0.75 with lower molecular weight HES 130/0.4 on albumin utilization in cardiac surgery, as well as any impact on renal function and bleeding.

Memantine-induced myoclonus and delirium exacerbated by trimethoprim.

Objective: To report a case of myoclonus and delirium seen in a patient taking a combination of memantine and trimethoprim.

Case Summary: A 78-year-old woman was admitted to the medical center in October 2007 with rapid deterioration of Alzheimer's dementia and progressive myoclonus. In 2003, donepezil 5 mg/day had been initiated and her disease slowly progressed.