Total facial nerve palsy following modified O'Brien facial nerve block

A 78-year-old white male developed a total facial palsy immediately following a modified O'Brien facial nerve block utilizing mepivacaine 2%, 10 cc. There was no apparent complication at the time of the nerve block. The facial palsy persisted unchanged for three months, at which time recovery of function was first detectable. Recovery was clinically complete nine months after the palsy occurred. The presumed cause was direct trauma by the needle at the time of the injection.