Would the same be true if the docs wanted to do trigger point injections of lidocaine for the fibromyalgia? I would imagine so.
Do they use the other 'caines for trigger point injections as well? Haven't heard of it. I'm seeing my PCP today for a follow-up.
Don't know that I'm really keen on the idea, but sometimes I really feel so uncomfortable.
Thanks - Lois

Type of Myotonia: Myotonia Congenita, Becker's type

Country: USA

Lois,

Usually the injections are a combination of lidocaine (Xylocaine) without epinephrine, bupivacaine (Marcaine) and a corticosteroid like Kenalog or Dexamethasone. Some substitute procaine (Novacain) for lidocaine.

I don't know how you'd do with the lidocaine...it seems to be more of an issue when you have hypokalemic conditions. Mexitil is actually structurally similar to Lidocaine and both are sodium channel blockers, so in theory it should actually help myotonia, but ONLY if you have the epinephrine-free solution.

I did some searches and many doctors just use Marcaine. However I did find a couple of lawsuits in Denver saying that two women who had the Marcaine injections had reactions (same doctor). One died and the other had a brain injury. I don't know if they got too much, if it was injected into a vein, or what. It does have a higher toxicity level. They did say in the report that this type of reaction was very rare and in fact they'd never seen it happen with trigger point injections, so I suspect it had to do with the doctor more than the anesthesia.

Some doctors use a technique called dry needling that seems to also get some results. Here's a good article from American Family Physician on Trigger Point Therapy:

Trigger Point Therapy

So now that I've thoroughly confused you, hopefully your doctor will discuss the pros and cons and you can come up with a plan

Jan

Type of Myotonia: Thomsen's MC

Country: US

Hi Leroy. Just to say many thanks for your message and taking the time to reply. It's much appreciated.

Caroline

I don't do well with dental anesthesia. Besides the lidocaines and the novacaines, I have reacted severely to nitreous oxide. My heart as well as my breathing slowed down . (Shortly after I was diagnosed fifteen years ago and before they know much more about anesthesia and myotonic disorders) I was on oxygen for quite a bit of time.

Why did I react so drastically to nitreous oxide?

Thanks,
Sheila

Type of Myotonia: Paramyotonia congenita

Country: USA

Sheila,

Often people with MC react to nitrous oxide in surgery because it's used along with the contraindicated inhalation anesthetics like halothane.

In dental use it shouldn't cause any problems in normal amounts unless you have a deficiency in glutathione or another condition like a pulmonary disease. There's also some evidence that it can cause problems if you're on antidepressants or similar therapy.

The reactions you described are common side effects from an overdose or toxic level. You may be much more sensitive than normal for a number of reasons, but in any case I would make sure it's in your dental and medical records.

I don't recall seeing NO contraindicated specifically for myotonia, including paramyotonia. So I suspect it is either a lung issue or a metabolism defect like an enzyme deficiency.

Jan

Type of Myotonia: Thomsen's MC

Country: US