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Dr.Tiwari
Dr.Tiwari, Doctor.
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Sporadic pulsating above my right ear, tight head pressure

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I have a sporadic pulsating above my right ear (right where the ear connects to the head) and very tight pressure on the top of my head (towards the back). This started when I got into bed a few minutes ago. Fot the past 2 weeks I have had ongoing, mild pressure and pains in my head (in various locations) as well as a few electric, shooting pains in this same area above my right ear. This is the first time the pressure has increased. I can feel the pulsating above my ear when I put my finger there and I cannot feel anything on the left side. A week ago my doctor ordered a brain MRI but my insurance company is holding off on the approval until they investigate to rule out pre-existing conditions (I just started with them in January). The pressure is very intense and I am very frightened. I have also had other symptoms although I do not know whether they are directly related. I have had mild pains in my back as well as very low pelvic pain on the right side. Additionally, I have a localized spot on my upper right buttock that started out as an itchy area and has progressed to a tender spot that feels under pressure. Yesterday I noticed a heaviness in my chest (directly in front of where the manubrium and sternum meet). I do not feel that my breathing is affected. I have never had pains or pressure-sensations like this in my head before and the pulsating above my ear is very alarming. I tried to lay down again and it got worse. I have had sinus headaches and infections before and this feels completely different. Your opinion is greatly appreciated. Thank you.
Submitted: 4 years ago.
Category: Health
Expert:  Dr.Tiwari replied 4 years ago.
Hello,
Will you please answer some questions so that i can help you-

1.Since when it is there?

2.What are the aggravating or relieving factors?

3.Have you taken treatment for diabetes /high blood pressure?

4.Any positive history of ENT INFECTIONS?

5.Are you generally stressed?

Please reply.
Customer: replied 4 years ago.

Will you please answer some questions so that i can help you-

1.Since when it is there?

I started having pressure in the back of my head about 3 weeks ago. On numerous occasions I have had a very quick, sharp, electric pain right above my right ear. This has only happened about 4 times. There has been a pressure at the top, dorsal region of my head that seems to get worse at very random moments. I have also experienced slight pains on the top of my head, in my jaw region, in my ear, etc. The majority of the sensation, however, is at the top/back portion of my head- all of this occurring in the last 3 weeks. About a week ago when I experienced a sharp pain above my right ear, I noticed that the blood vessel in that location felt enlarged. Last night when I got into bed, I felt a strong increase in pressure at the back of my head and the pulsating sensation appeared above my right ear. I woke up this morning and the pulsating is still occurring (only on the right side). The vessel is still enlarged. I cannot help but worry that I have a blood clot, an aneurysm, or some kind of latent viral or bacterial infection. Just to reiterate what I mentioned in my initial question, I have also had these symptoms over the last 3 months (I do not know whether they are related): a localized tenderness/pressure in my upper right buttock, intermittent upper back pain, sore sacral bone, lower right groin pain (pain comes at random moments and is associated with pain down inner right thigh). Over the past 1.5 weeks I have woken up each morning with this very subtle sense that I am tremblin in my head, neck and arms. It is not visible, so I do not know whether it is a strange neurological symptom/sensation of what is going on or whether I am in fact slightly trembling.

2.What are the aggravating or relieving factors?

I honestly cannot account for anything that causes or relieves the sensations. They occur at random. The only thing that seemed to play a role was lowering my head when I got into bed last night. Yet at other times these symptoms occur when standing, sitting, etc. The pain is not intense (except for the few sharp pains above my ear). In fact, the pressure is mild. The fact that it has been constant over 3 weeks is what worries me and the fact that I also have been having the enlarged vessel with noticable pulsations.

3.Have you taken treatment for diabetes /high blood pressure?

I have never had diabetes nor high blood pressure. In fact, my blood pressure is a slightly lower than average. My cholesterol levels (both LDL and HDL) are fantastic.

4.Any positive history of ENT INFECTIONS?

I have had post-nasal drip since I was a child and I have also had numerous sinus infections in my life. I can honestly say that the symptoms and pressure locations at present are distinctly different from past ENT infections.

5.Are you generally stressed?
Yes, I have been stressed, but please do not attribute these symptoms to anxiety. I have felt stress and anxiety in the past with physical symptoms such as rapid heart rate, headache, etc, but those symptoms were very different from I have now.

I fully understand the difficulty in diagnosing someone over the internet. I just hope that I can get some feedback as to what these symptoms might signal to you. I just had some blood drawn for various tests sush as the CRP, ANS, ENA, TSH, B12, Vit D, West Nile Virus, Lead Toxicity, and Lupus and will get those results back in a week or so. Also, can you please inform me as to whether the enlarged vessel with strong pulsations are possible symptoms of any emergency situation? I have been debating going to the ER as I do not know whether it could be serious. Thanks so much for your time, I sincerely XXXXX XXXXX input. Jennie


Expert:  Dr.Tiwari replied 4 years ago.
Thanks Jennie for detailed information.

Jennie,i will first want to explain you some diagnosis which you have mentioned.You are having the fear of -

1.Aneurysm; In aneurysm there is continuous feeling of the pulsation in head or ear if there is aneurysm in the carotid artery.You may have an enlarged artery with visible & palpable pulsation which IS CONTINUOUS IN anureysm & this is not with you.

2.In a blood clot in brain which suddenly blocks a artery there ios sudden motor or sensory changes in part supplied by the brain or its part which is affected by clot.

3.Infection: Infection in brain or other part will be manifested by fever which may be intermittent or continuous with associated general symptoms.

You are having pain at the multiple sites.This is a polymyalgia such type of symptoms are generally found with the-

1.Rheumatoid arthritis where stiffness should also be there specially in morning.

2.Inflammatory myositis which does include multiple causes & this does consist of multiple muscle pain which is generally continuous with/without fever.

3.Fibrosists : which does include multiple localized area of inflammation.

4.Polymyalgia rheumatica : which generally starts in old age near 70yrs , joints like shoulder & hip are affected first in this.

5.Stress: Although you are denying for that but you should keep this factor also in your list as stress by changing the levels of chemicals in the brain does lead to feeling of muscle pain with fatigue,morning headache ,palpitation with hearing of it in ear.


To exclude all this you do really need blood tests like Hb,TDLC,ESR,RA FACTOR,CRP & OTHERS.Till then you may do following to have relief-

1.You may have a mild anti inflammatory analgesic like advil/tylenol.

2.Keep your self relaxed & avoid excessive physical & mental exertion.

3.Start doing yoga & meditation.If you do it under supervision then there is no harm in doing it.

4.Depending on your report your doctor may prescribe you steroid medicines or some sedative drugs for few days.

Hope this will help you.

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Dr.Tiwari, Doctor.
Category: Health
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