A rare event of vestibular complication following percutaneous trigeminal radiofrequency ablation

We report here to draw attention to an uncommon complication that could arise from routinely performed procedure in pain practice such as percutaneous trigeminal radiofrequency ablation (RFA). We report a case of a 53-year-old female who underwent trigeminal nerve RFA for trigeminal neuralgia. RFA after adequate assessment with sensory and motor stimulation is performed as a routine procedure followed by 0.2 ml 1% lignocaine for dense sensory block at the target, following which the patient developed giddiness, nausea, vomiting, and nystagmus. After 2 h of rest and gaze fixation, her symptoms improved, with a decline in the severity of nystagmus. Symptoms gradually resolved over a period of 3 h. Proximity of the membranous part of the auditory tube to the foramen ovale might lead to such mishaps. Direct administration of 1% lignocaine into the middle ear via the auditory tube might be the most likely reason for her condition.