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Suggest Treatment For Low BP, Horner Syndrome, Arm Pain And Dizziness
Question: I was writing to Dr. XXXXXXX XXXXXXX Neurologist about my condition. I would hate to rewrite the whole problem. Basically, I have low blood pressure when standing up or sitting up, and have Horners Syndrome. Nice article on the web by Merck Manuals on Overview of the Autonomic Nervous System. I have a plate, two rods, and twelve screws in my neck from two operations. Feel off a ladder. Neurologist where I live stated it could be coming from the neck, a compressed nerve, however, MRI does not show anything. She has no solutions to correct the problem, and I can't live in the house the rest of my life. Who at this point should I see? Should I get a thorax CT Scan to rule out any tumors there? I'm on blood pressure medication to stop the dizziness and not much I can do about the Horners as the right eye droops.
My arms hurt once in awhile as well as the area on the very left part of my chest (left side). I have been taking Oxycodone (2 x 20mg day), Gralise (1800mg at dinner) and Lidocaine patches at bedtime.
Can no longer drive or do stressful exercises. Even walking is a problem due to dizziness.
I had a hard time finding a surgeon between 1st and 2nd neck operation. I doubt if any doctor would come near me at this point, but I need the help.
Which doctor should I see? Neurosurgeon? Cardiologist? I am having a tilt table test done in two weeks. Should I wait to see the results first before seeing a doctor?
My arms hurt once in awhile as well as the area on the very left part of my chest (left side). I have been taking Oxycodone (2 x 20mg day), Gralise (1800mg at dinner) and Lidocaine patches at bedtime.
Can no longer drive or do stressful exercises. Even walking is a problem due to dizziness.
I had a hard time finding a surgeon between 1st and 2nd neck operation. I doubt if any doctor would come near me at this point, but I need the help.
Which doctor should I see? Neurosurgeon? Cardiologist? I am having a tilt table test done in two weeks. Should I wait to see the results first before seeing a doctor?
Brief Answer:
Consult neurosurgeon with tilt table report
Detailed Answer:
Hello dear,
I have gone through your question and understand your concerns.
Tilt table test is done for evaluating autonomic dysfunction. You can go for this test with precautions regarding stability of neck during testing.
Gralise at 1800 mg dose may be a cause of dizziness and if possible should be reduced.
Pain can be managed by using duloxetine, nortryptiline. Neurosurgeon can be consulted to evaluate regarding possibility of minimally invasive operative management of foraminal stenosis. If successful then drugs and doses for pain relief may be reduced and also their side effects.
You can wait till the tilt table testing and then get a consultation from a neurosurgeon.
You can also try exercises for autonomic dysfunction related hypotension.
You can use compression stockings, prefer moving legs before standing from supine or sitting position, standing in cross leg position.
What anti hypertensive drugs you are on.
Hope you found the answer helpful.
Do get back to me for further queries
Regards
Dr Neeraj Kumar
Neurologist
Consult neurosurgeon with tilt table report
Detailed Answer:
Hello dear,
I have gone through your question and understand your concerns.
Tilt table test is done for evaluating autonomic dysfunction. You can go for this test with precautions regarding stability of neck during testing.
Gralise at 1800 mg dose may be a cause of dizziness and if possible should be reduced.
Pain can be managed by using duloxetine, nortryptiline. Neurosurgeon can be consulted to evaluate regarding possibility of minimally invasive operative management of foraminal stenosis. If successful then drugs and doses for pain relief may be reduced and also their side effects.
You can wait till the tilt table testing and then get a consultation from a neurosurgeon.
You can also try exercises for autonomic dysfunction related hypotension.
You can use compression stockings, prefer moving legs before standing from supine or sitting position, standing in cross leg position.
What anti hypertensive drugs you are on.
Hope you found the answer helpful.
Do get back to me for further queries
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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