Oculomotor palsy following dental anesthesia

Paralysis of the right third and fourth cranial nerves, lasting for about six weeks, occurred in a patient following the injection of procaine hydrochloride in the area of the right superior alveolar artery. Ocular complications of dental anesthesia are rare and are probably caused by intra-arterial injection of anesthetic that reaches the orbit via an anastomosis between the middle meningeal and ophthalmic arteries. Such complications include transient oculomotor palsies and permanent or transient loss of vision.