Post TON block dizziness

[oneforfighting]

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I know that temporary dizziness can occur following TON blocks but I haven't seen a discussion on whether or not that translates to sustained dizziness following RFA. I have a patient complain of this for a few hours following TON/C3 MBBs x2. Plan on doing unilateral RFs but want to know how to proceed if she complains of dizziness after the first side. Hold off on doing the opposite side until symptoms resolve?

 

[kstarm]

Usually I schedule the RFA 2 weeks apart and do not have issues with people having ongoing dizziness. I guess if someone still was having issues I would hold off on doing the other side until it resolved if I thought it was related to the procedure.

 

[pmrmd]

I know that temporary dizziness can occur following TON blocks but I haven't seen a discussion on whether or not that translates to sustained dizziness following RFA. I have a patient complain of this for a few hours following TON/C3 MBBs x2. Plan on doing unilateral RFs but want to know how to proceed if she complains of dizziness after the first side. Hold off on doing the opposite side until symptoms resolve?

Hold off? Yes.

Patient may blame the procedure, and you by extension, whether it has something to do with it or not.

Provide reassurance above all.

 

[oneforfighting]

Hold off? Yes.

Patient may blame the procedure, and you by extension, whether it has something to do with it or not.

Provide reassurance above all.

Do you typically see dizziness after blocks and then rfa as well?

 

[SpineandWine]

I know that temporary dizziness can occur following TON blocks but I haven't seen a discussion on whether or not that translates to sustained dizziness following RFA. I have a patient complain of this for a few hours following TON/C3 MBBs x2. Plan on doing unilateral RFs but want to know how to proceed if she complains of dizziness after the first side. Hold off on doing the opposite side until symptoms resolve?

Your meds went anterior
Esp if you took mid trapezoid approach

 

[pmrmd]

Blocking 2-3 causes some dizziness

 

[1 Up]

I regularly do BL C2-3, and about 30% of patients experience brief ataxia. This is a well known side effect. We then do the RFA 2 weeks apart, and they have no issues. Very common.

 

[BoardingDoc]

I regularly do BL C2-3, and about 30% of patients experience brief ataxia. This is a well known side effect. We then do the RFA 2 weeks apart, and they have no issues. Very common.

Why 2 weeks apart? Concern about head drop?

 

[Taus]

Why 2 weeks apart? Concern about head drop?

Global period

 

[BoardingDoc]

Global period

I more meant why not simply do bilateral. I know that some people do staged unilateral because of concern for head drop. This thread is talking about ataxia with upper cervical MBBs though so I was wondering if there was another reason why people are avoiding unilateral.

I still do BL for all cervical MBB and RFA. I warn everyone about the head drop risk but also explain that it's very rare.

 

[Ducttape]

RFA each side 2 weeks apart is for head drop concerns.

RFA 2 weeks after MBB is required by some insurances.