AUDITORY, OCULAR, AND FACIAL COMPLICATIONS OF CENTRAL NEURAL BLOCK - A REVIEW OF POSSIBLE MECHANISMS

Background and Objectives. The purpose of this review is to draw toget her a collection of uncommon complications of central neural block tha t affect the cranial nerves. There have been a small number of case re ports, some of which have included a possible mechanism of the nerve d ysfunction, but there is no prior review that collected them together and discussed the possible mechanisms. Methods. Published case reports were identified by searching Medline of the British Medical Associati on and the Silver Platter CD-ROM library. In addition, the Medical Def ence Union and Medical Protection Society were contacted to find cases that were unpublished but the subject of medical negligence lawsuits. Results. The authors collected these cases together to increase aware ness of alarming complications. If such cases are recognized for what they are, then the prognosis is good; however, delayed diagnosis can m ake them a cause of great anxiety and possible litigation. Conclusions . Increased awareness of these complications can decrease the likeliho od of litigation by early diagnosis and explanation. Their mechanisms are not fully understood but the likely possibilities have been discus sed. Further work is needed to establish the incidence of these proble ms, as it is likely that many cases are not diagnosed and not reported .