Ipsilateral, isolated amaurosis after inferior alveolar nerve block: report of two rare cases.

BACKGROUND: Local anesthetics are utilized all over the world for performing painless dental procedures. Usually, the administration of local anesthetic is an uncomplicated process that passes off uneventfully. Complications, when seen, are not usually serious. However, blindness is an alarming complication both for the patient and for the dentist. Amaurosis can occur with both maxillary and mandibular nerve blocks. Amaurosis is usually associated with other ocular complications like ptosis, diplopia, and periorbital blanching. CASE REPORT: We report two rare cases of transient isolated amaurosis. Both the instances of amaurosis were seen after inferior alveolar nerve blocks. The condition was transient and resolved without any active intervention. DISCUSSION: Though permanent amaurosis has been reported, it is usually transient in nature. Various causes have been proposed like intravascular injection, sympathetic impulse generation, and embolism. The etiology in the present case was believed to be intravascular injection.

Amaurosis, ophthalmoplegia, ptosis, mydriasis and periorbital blanching following inferior alveolar nerve anaesthesia.

BACKGROUND: Ophthalmic complications following inferior alveolar nerve anaesthesia are rare. They include transient blindness (amaurosis), ophthalmoplegia, ptosis, mydriasis and diplopia. These events may occur following the intravascular administration of anaesthetic solution and are distressing to both patient and operator alike. CASE REPORT: We report the unusual case of a young patient who experienced amaurosis, total ophthalmoplegia, complete upper eyelid ptosis, mydriasis and periorbital blanching following inferior alveolar nerve anaesthesia. Similar but less profound signs were observed in the same patient on a subsequent occasion. This was following general anaesthesia, during which she had received local anaesthetic prior to mandibular wisdom tooth removal. CONCLUSIONS: Ophthalmic complications following inferior alveolar nerve anaesthesia are rare but distressing events. In particular, amaurosis is an extremely rare event and usually heralds a more sinister pathology such as stroke. Clinicians should be aware of these complications to minimise anxiety and reassure their patients appropriately.

Amaurosis cortical transitoria por Metotrexato. A propósito de un caso / Transient cortical blindness due to Methotrexate. Report of a case

Propósito: Presentar un caso de amaurosis bilateral en el contexto de una encefalopotía metabólica en una paciente tratada por un linfoma de alto grado de malignidad mediante un esquema de poliquimioterapia que incluía Citarabina, Vincristina y Metotrexato como principales drogas neurotóxicas. Material y métodos: Paciente de 29 años que presentó una amaurosis cortical bilateral en el contexto de un síndrome de lisis tumoral tras administración de quimioterapia, comprometiéndose el aclaramiento plasmático de Metotrexato, citostático al que atribuimos la clínica neurológica que se describe y analiza. Resultado: La neurotoxicidad revirtió completamente tras el tratamiento de rescate con Leucovorin. Conclusiones: La amaurosis cortical es un tipo de toxicidad neurológica aguda del Metotrexato transitoria y reversible. Su tratamiento se basa en el soporte hemodinámico y el uso de Leucovorin (AU)