Transient glossopharyngeal nerve palsy due to mandibular nerve block

Abstract

Local anaesthesia in dental procedures is considered safe. Few cases of neurological complication have been reported, most of which involve the lingual or inferior alveolar nerve. We report a case of a woman in her late 40s who 30 min after administration of local anaesthetic in the right pterygomandibular space (articaine and mepivacaine) developed nasal speech and numbness in the area around external auditory meatus. Uvula was deviated to the left. No facial palsy or diplopia were observed. The symptoms subsided gradually after 3 hours. Clinical symptoms were attributed to glossopharyngeal nerve palsy. Glossopharyngeal nerve palsy after mandibular nerve block has never been reported before. Reporting cases of neurological complications of a very common and generally safe procedure help in increasing the awareness of potential risks considering the anatomical complexity and variability of the orofacial area.