Brainstem anesthesia presenting as dysarthria

After having a retrobulbar injection for anesthesia before cataract surgery , a patient developed dysarthria. This was the presenting sign for penetrat ion of the optic nerve sheath by the retrobulbar injection, with subsequent brainstem anesthesia,Thereafter, the patient demonstrated cranial nerve dy sfunctions with tongue deviation, tachycardia, hypertension, and contralate ral sixth and third nerve palsies. I believe this is the first documented c ase in which dysarthria is the presenting sign for brainstem anesthesia res ulting from a retrobulbar injection. (C) 1999 ASCRS and ESCRS.