Local Anaesthesia Systemic Toxicity (LAST) – A Stroke Mimicker

Leong, Tan Toh

doi:10.17576/mh.2019.1401.27

Cited by 2 publications

(1 citation statement)

References 8 publications

(12 reference statements)

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“…Pertaining to this case, the timing of her signs and symptoms correlates with the onset and duration of the local anaesthesia given, hence suggesting that her symptoms correlate with the inferior alveolar nerve block injection. Local anesthetic systemic toxicity (LAST) has been reported to cause a stroke mimicker [22]. However, given the duration of rapid recovery, toxicity is unlikely in this case.…”

Section: Discussionmentioning

confidence: 81%

A stroke mimicker following inferior alveolar nerve block: a case report

Hassan

Singh

Selvaraju

et al. 2023

J Oral Med Oral Surg

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Introduction: Local anesthesia administration albeit being the most common dental procedure is associated with complications that usually arise as a result of wrongly placed injections into local or distant sites. Here we present a case of an unexpected complication affecting the upper limb after dental anesthesia administration. Observation: A 26-year-old Malay female presented with the left upper extremity paralysis and paraesthesia following the administration of a local anesthesia block to the left inferior alveolar nerve, at a dental teaching center. The onset of the dental nerve block and left upper extremity weakness occurred and eventually subsided. As the provisional diagnosis was either a transient ischaemic attack or stroke, she was immediately referred to the Emergency Department. She was thoroughly assessed and monitored with the neurology team being consulted. Her vital signs remained stable and she showed no neurological deterioration throughout the observation period. She was discharged without further investigations after regaining full strength and sensation of her left upper extremity. The report tries to hypothesize the possible cause of this incident. Conclusion: This case highlights the importance of dentists being alert to possible effects of local anesthesia to regions beyond the head and neck area.

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Section: Discussionmentioning

confidence: 81%

A stroke mimicker following inferior alveolar nerve block: a case report

Hassan

Singh

Selvaraju

et al. 2023

J Oral Med Oral Surg

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Sudden quadriparesis after non-overdose local anesthesia

Chen

Weng

et al. 2022

Int J Emerg Med

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Background A well-known anesthetic, lidocaine is the most widely used local anesthetic. Local anesthetic systemic toxicity (LAST) is a life-threatening event with common and prominent presentations of central nervous system (CNS) toxicity and cardiovascular toxicity. The most frequent and prominent early warning signs and symptoms of LAST are central nervous system symptoms. While rare, cases quadriparesis after the administration of lidocaine has been reported. Case presentation In this paper, we report a very rare case of quadriparesis after local anesthesia administration for vocal cord cyst-removal surgery, which dramatically improved after treatment. LAST can occur during various routes of lidocaine administration, such as local spray. A possible mechanism of our case could be the local diffusion of lidocaine to the spinal cord, which caused the symptoms to mimic anterior cord syndrome. Conclusions Our case presented a favorable outcome following the administration of intravenous lipid emulsion (ILE) for non-over dose local anesthetic drug induced spinal cord inhibition symptoms. These findings highlight the need for further research on the use of ILE to reverse LAST and other adverse effects of local anesthetics.

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Local Anaesthesia Systemic Toxicity (LAST) – A Stroke Mimicker

Cited by 2 publications

References 8 publications

A stroke mimicker following inferior alveolar nerve block: a case report

A stroke mimicker following inferior alveolar nerve block: a case report

Sudden quadriparesis after non-overdose local anesthesia

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