Inflammatory trigeminal nerve and tract lesions associated with inferior alveolar nerve anaesthesia

J Clin Neurosci. 2013 Nov;20(11):1608-10. doi: 10.1016/j.jocn.2012.10.027. Epub 2013 Apr 13.

Abstract

Inferior alveolar nerve blocks are commonly performed for dental anaesthesia. The procedure is generally safe with a low rate of complications. We report a patient with a reproducible, delayed-onset sensory deficit associated with contrast-enhancing lesions in the trigeminal nerve, pons and medulla following inferior alveolar nerve local anaesthesia. We propose that this previously undescribed condition is a form of Type IV hypersensitivity reaction.

Keywords: Delayed hypersensitivity; Inferior alveolar nerve; Local anesthesia; Magnetic resonance imaging; Trigeminal nerve; Trigeminal nuclei.

Publication types

  • Case Reports

MeSH terms

  • Anesthesia, Dental / adverse effects*
  • Anesthesia, Dental / methods
  • Anesthetics, Local / adverse effects*
  • Anti-Inflammatory Agents / therapeutic use
  • Brain / pathology*
  • Humans
  • Inflammation / chemically induced
  • Inflammation / drug therapy
  • Male
  • Mandibular Nerve / drug effects*
  • Middle Aged
  • Nerve Block / adverse effects*
  • Trigeminal Nerve / pathology*

Substances

  • Anesthetics, Local
  • Anti-Inflammatory Agents