Reactions 1346 - 9 Apr 2011

SMepivacaine

Bell’s palsy: case reportA 34-year-old woman developed Bell’s palsy after

receiving an inferior alveolar nerve block with mepivacaine[Scandicaine].

The woman, who was 35 weeks pregnant, presentedwith pain in her mandibular left second molar in October2008 and was diagnosed with irreversible pulpitis. Shereceived an inferior alveolar nerve block with an injection of1.8mL of mepivacaine [dose not clearly stated]. Apulpotomy was then performed, after which she wasprescribed paracetamol [acetaminophen] for analgesia.Two hours later, she developed rapid and completeparalysis of the left-side facial muscles. She presented to anED and was admitted. Examination showed absence of leftforehead and facial creases, as well as naso-labial fold,drooping of the left lower eyelid and asymmetry of the leftcorner of the mouth. She was unable to close her left eyelidor smile properly and reported discomfort on eating. Shewas diagnosed with complete Bell’s palsy (House-Brackman grade VI).

The woman received an eye lubricant to preventophthalmic damage, but received no further treatment toeliminate any risk to the foetus. She delivered her baby inNovember 2008, after which there was no change to herparalysis. Three months after paralysis onset, hersymptoms began to improve. She continued to showprogressive recovery and by 1 year after onset she hadmade a significant improvement, with a persistent slightmuscular stiffness of grade I/grade II. She continued toundergo regular follow-up.Chevalier V, et al. Facial palsy after inferior alveolar nerve block: case report andreview of the literature. [Review]. International Journal of Oral and MaxillofacialSurgery 39: 1139-42, No. 11, Nov 2010 - France 803052353

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Reactions 9 Apr 2011 No. 13460114-9954/10/1346-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved