title: Deterioration of Kearns-Sayre syndrome following articaine administration for local anesthesia.
abstract: Worsening of the neuromuscular manifestations in Kearns-Sayre syndrome after administering local anesthesia with articaine has not been reported. The authors describe a severe adverse reaction to local anesthesia with articaine for tooth extraction in a 28-year-old woman with Kearns-Sayre syndrome due to a 5.9-kb mitochondrial DNA deletion. The patient was subjected to local anesthesia with 1.5 mL (60 mg) articaine in the left submandibular nerve for tooth extraction. Five minutes after the injection the patient developed weakness of the limb muscles, extreme fatigue with increased desire to sleep, a feeling of heat, inappetence, and frequent urination. The adverse reaction resolved spontaneously within 48 hours without sequelae. Administration of articaine may cause severe side effects in patients with Kearns-Sayre syndrome. Articaine should be used with caution in these patients.
authors.affiliation: Neurological Department, Krankenanstalt Rudolfstiftung, Vienna, Austria. duarte@aonmail.at
authors.forename: Josef
authors.initials: J
authors.lastname: Finsterer
authors.forename: Christine
authors.initials: C
authors.lastname: Haberler
authors.forename: Janet
authors.initials: J
authors.lastname: Schmiedel
mesh_terms: D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000009:adverse effects*; D002355:Carticaine / Q000009:adverse effects*; D004272:DNA, Mitochondrial / Q000235:genetics; D005260:Female; D006801:Humans; D007625:Kearns-Sayre Syndrome / Q000139:chemically induced*; D008875:Middle Aged; D014081:Tooth Extraction
chemical_list: D000779:Anesthetics, Local; D004272:DNA, Mitochondrial; D002355:Carticaine