Cranial-nerve Palsies with Herpes following General Anaesthesia

Abstract

Thirteen cases of cranial nerve palsy following general anesthesia are reported and a typical and 2 fatal cases are described. The nerves involved were mainly the 5th and 7th, but the 3rd, 4th, 6th, 10th, and 12th were involved in some cases. The condition was associated with labile herpes in 9 cases. No preanesthetic drug was common to all cases but all were administered on a circle absorber anesthetic machine. Evidence is given for chemical reactions between soda lime and trichloroethylene in the system with the production of dichloroacetylene. Preliminary results show that this substance is toxic in rabbits producing a picture of encephalitis. Antibodies against herpes were found in the sera of all cases. It is concluded that trichloroethylene should not be used when there is any possibility of its coming into contact with soda lime.