A curious case of unexplained physical reaction to dental local anaesthetic

This case report aims to highlight a very unusual adverse reaction to local anaesthetic, along with the implications for providers of dental treatment. Local anaesthetics (LA) are commonly used in dentistry to allow for pain‐free dental treatment. Adverse reactions to LA are reported to be very rare...

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Bibliographic Details
Published in:Oral surgery 2017-11, Vol.10 (4), p.239-242
Main Authors: Crane, H., Carter, A., Andresen, E.
Format: Article
Language:English
Subjects:
allergy
Anesthetics
Dentistry
Hypersensitivity
local anaesthetic
Local anesthesia
Pain
Side effects
somatic symptom and related disorders
Syncope
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Summary:This case report aims to highlight a very unusual adverse reaction to local anaesthetic, along with the implications for providers of dental treatment. Local anaesthetics (LA) are commonly used in dentistry to allow for pain‐free dental treatment. Adverse reactions to LA are reported to be very rare and are generally categorised into three groups; psychogenic, allergic and toxic. This case highlights a reaction which does not easily fit into one of these groups, where a patient appeared to become unconscious, with a hypotonic arm and became non‐communicative following every administration of LA. It took the patient up to an hour to recover from these episodes, unlike a normal episode of syncope which usually only takes a few minutes to recover from. Local anaesthetic direct challenge testing was performed, which proved there was no true allergic response to LA. This response appeared typical of conversion syndrome, a type of somatic disorder, which is a very unusual response to dental treatment. The complications to consider when managing these patients are discussed.
ISSN:1752-2471
1752-248X
DOI:10.1111/ors.12252