Session Information
Session Title: AA 2021 Virtual Posters - Pain and Spine Medicine
Session Time: None. Available on demand.
Disclosures: Kellen A. Hilton, MS, MD: No financial relationships or conflicts of interest
Case Diagnosis: This is a 58-year-old woman with myotonic dystrophy type 2 with chronic neuropathic calf pain treated with lidocaine infusions.
Case Description: The patient is treated for spasticity of her bilateral plantar flexors with botulinum toxin injections every three months. She has pins and needles type pain sensations of the bilateral calves which typically recur approximately 8 weeks after her injections. As traditional first-line treatments did not provide adequate relief, the patient underwent a trial of lidocaine infusion. After appropriate screening including basic labs and electrocardiogram, the patient was infused with a total of 450mg of lidocaine over one hour. There were no adverse effects reported as a result of infusion.
Setting: Multidisciplinary Outpatient Pain ClinicAssessment/
Results: The patient received immediate partial pain relief and resolution of her neuropathic calf pain following lidocaine infusion. At two-week follow-up the patient continued to endorse resolution of symptoms and did not endorse any adverse side effects or sequelae of infusion. She has undergone continued infusion therapy every three months and continues to endorse resolution of her neuropathic pain for the past 18 months.
Discussion: Patients with myotonic dystrophy have increased sensitivity to some anesthetic agents. To our knowledge, this is the first known documented case of successfully utilizing lidocaine infusion for the treatment of pain in a patient with myotonic dystrophy.
Conclusion: This case suggests that lidocaine infusion, when utilized correctly with appropriate safety measures, may be a safe and efficacious therapy for chronic pain that is refractory to first line treatments in this unique patient population.
Level of Evidence: Level V
To cite this abstract in AMA style:
Hilton KA, Poliak-Tunis M. Lidocaine Infusion for Chronic Pain in a Patient with Myotonic Dystrophy Type 2: A Case Report [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/lidocaine-infusion-for-chronic-pain-in-a-patient-with-myotonic-dystrophy-type-2-a-case-report/. Accessed May 17, 2025.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/lidocaine-infusion-for-chronic-pain-in-a-patient-with-myotonic-dystrophy-type-2-a-case-report/