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Prolonged diplopia following a mandibular block injection.
1Department of Oral Medicine and Periodontics, Faculty of Dentistry, University of Stellenbosch, Tygerberg, South Africa.
Anesthesia Progress
|October 1, 1996
Summary
A teenage girl experienced temporary double vision after a dental injection of lidocaine with epinephrine. The unusual onset and duration suggest current theories may not fully explain this rare local anesthetic complication.
Area of Science:
- Dentistry
- Anesthesiology
- Ophthalmology
Background:
- Local anesthetics like lidocaine with epinephrine are commonly used in dental procedures.
- Complications from local anesthetics, though rare, can occur.
- Understanding the mechanisms of adverse events is crucial for patient safety.
Observation:
- A 14-year-old female patient developed diplopia (double vision) following administration of Xylotox E 80 A (2% lidocaine with 1:80,000 epinephrine).
- The diplopia presented with a slow onset and persisted for 24 hours.
- No specific treatment was required beyond reassurance, and the patient achieved full recovery.
Findings:
- The slow onset and prolonged duration of diplopia in this case challenge conventional explanations involving vascular, lymphatic, or direct neural spread theories.
- This suggests potential alternative or less understood mechanisms for local anesthetic-induced neurological side effects.
Implications:
- The case highlights the need for further investigation into the etiology of delayed neurological complications following local anesthetic administration.
- Clinicians should be aware of this rare but possible adverse event and provide appropriate patient counseling and management.
- Further research may refine our understanding of local anesthetic neurotoxicity and improve injection techniques to minimize risks.