Concomitant horner and harlequin syndromes after inferior alveolar nerve block anesthesia.
BACKGROUND
Intraoral anesthesia is probably the most commonly used procedure in dentistry.


METHODS
Although inferior alveolar nerve block (IANB) anesthesia is one of the safest procedures to anesthetize the mandibular teeth, side effects of IANB anesthesia can still give rise to potential risks for patients. Fortunately, most observed alterations are transient and self-limited.


RESULTS
The complications of IANB anesthesia are varied in nature and could be specifically categorized into systemic, localized, and distant complications. When the complications occur around the orofacial structures including the temporomandibular joint, middle ear, facial skin, and the eye, which are away from the oral cavity, it can be defined as distant complications. However, to our best knowledge, the concomitant occurrence of neurologic phenomena such as Horner syndrome combined with cutaneous complications in a patient receiving IANB anesthesia has never been discussed.


CONCLUSIONS
In this exceptional case, the unusual Horner syndrome manifestations related to unilateral ptosis, miosis, and anisocoria were simultaneously developed with skin ischemia, paresthesia, and asymmetric flushing after the administration of IANB anesthesia.
Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan. Electronic address: ndmcandy@ndmctsgh.edu.tw.
Ren-Yeong
RY
Huang
Ying-Jen
YJ
Chen
Wen-Hui
WH
Fang
Lian-Ping
LP
Mau
Yi-Shing
YS
Shieh
D000328:Adult; D000766:Anesthesia, Dental / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects; D001342:Autonomic Nervous System Diseases / Q000139:chemically induced*; D004837:Epinephrine / Q000009:adverse effects; D005145:Face / Q000098:blood supply / Q000294:innervation; D005260:Female; D005483:Flushing / Q000139:chemically induced*; D006732:Horner Syndrome / Q000139:chemically induced*; D006801:Humans; D007007:Hypohidrosis / Q000139:chemically induced*; D007511:Ischemia / Q000139:chemically induced; D008012:Lidocaine / Q000009:adverse effects; D008340:Mandibular Nerve; D009407:Nerve Block / Q000009:adverse effects*; D010292:Paresthesia / Q000139:chemically induced; D014662:Vasoconstrictor Agents / Q000009:adverse effects
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine
Complications; Horner’s syndrome; harlequin syndrome; irreversible pulpitis; lidocaine; local anesthesia