Temporary paralysis of cranial nerves III, IV, and VI after a Gow-Gates injection.

A case of temporary complete paralysis of cranial nerves III, IV, and VI, after a Gow-Gates injection is reported. The proposed explanations for the mechanisms of occurrence are described. Although the Gow-Gates technique has many advantages, it is not without complications. To avoid such complications, it is important to take the following precautions when using the Gow-Gates technique: because of the proximity of the internal maxillary artery (accessory and middle meningeal) and the pterygoid plexus of veins, and because the anesthetic is injected quickly, it is paramount that careful aspiration be performed before administration of the local anesthesia; injections should be on or within 1 mm to 2 mm of the condylar neck.