title: Inflammatory trigeminal nerve and tract lesions associated with inferior alveolar nerve anaesthesia.
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.
authors.affiliation: Department of Neurology, Royal North Shore Hospital, Pacific Highway, St Leonards, 2065, New South Wales, Australia.
authors.forename: N F
authors.initials: NF
authors.lastname: Blair
authors.forename: J D E
authors.initials: JD
authors.lastname: Parratt
authors.forename: R
authors.initials: R
authors.lastname: Garsia
authors.forename: D H
authors.initials: DH
authors.lastname: Brazier
authors.forename: P D
authors.initials: PD
authors.lastname: Cremer
mesh_terms: D000766:Anesthesia, Dental / Q000009:adverse effects* / Q000379:methods; D000779:Anesthetics, Local / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000139:chemically induced / Q000188:drug therapy; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects*; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects*; D014276:Trigeminal Nerve / Q000473:pathology*
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents
keywords: Delayed hypersensitivity; Inferior alveolar nerve; Local anesthesia; Magnetic resonance imaging; Trigeminal nerve; Trigeminal nuclei