1993 Volume 8 Issue 2 Pages 129-134
A 49-year old female patient suffered loss of consciousness following local anesthesia 15 previously. Frequent headaches and vomiting continued for a period following extraction of all 3rd molar teeth under sedation 10 years previously.
The patient was referred to our department because of the above-mentioned history by a practitioner to whom she went complaining of discomfort. She had been under treatment for angina pectoris from 7 to 8 years previously and suffered a light attack of angina in May, 1989.
The patient exhibited breathing difficulties, dizziness, increase in blood pressure and pulse, and complained of headache immediately after a subcutaneous injection of 0.5% xylocain®, however no relation to angina was found by medical examinations. Results of allergy tests in the department of dermatology suggested that only the use of 1% carbocain® was permissible (xylocain® and procaine® were not tested due to an antecedent of anaphylactic shock). However the same symptoms were observed using 1% carbocain®. Under resumption of allergy tests to carbocain® and xylocain®, although slight increases in pulse were observed, not only administration but also gradual increase in concentration and dose became possible. This condition allowed the extraction of 7. However each treatment required considerabletime as the abovementioned symptoms occurred immediately after each administration of local anesthesia, and despite the distressed facial expression of the patient, only a slight increase in physiological responses was observed. The same condition was observed under 30% nitrous oxide sedation, yet the patient demanded a prompt ending of treatment. The observed inconsistencies, along with clinical observations from interviews and results of the Rorschach Test suggested a conversion disorder behind these symptoms.
