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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor (MD/DO)
Category: Health
Satisfied Customers: 6400
Experience:  MBBS, MD, ECFMG certified. 11 year experience in dealing with cases related to all fields of medicine
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I have a non pain intermittent throbbing/pulsating on the

Customer Question

I have a non pain intermittent throbbing/pulsating on the left side of my neck. It occurs occasionally and then goes away for a day or two. I notice it early in the morning after sleeping at night and during the day while driving, sitting at my desk orstanding. I am 70 years old in good health, exersize regularly and not overweight at all. I recently had my annual medicare physical, but did not mention this because
JA: How long have you been dealing with the neck pain? Are you experiencing any numbness or tingling?
Customer: There is no pain at all associated with the throbbing, just a nuisance. The throbbing has been occurring off and on for about a week. I have noticed some minor numbness in my feet(toes) for quite a while.
JA: Is there anything else in your medical history you would like the doctor to know?
Customer: Blood pressure is always goow and on the low side for as long as I can remember. No other issues. Outside of this I feel really good. I am on a very low dose statin, cholesterol is within limits. I have just begun taking Merbetriq for too frequent urination and it seems to be alleviating the problem.
Submitted: 8 months ago.
Category: Health
Expert:  Dr. Muneeb Ali replied 8 months ago.

Hi,

Im sorry to hear about your symptoms. Can i ask what is your age? Do you have any associated headaches, blurring of vision, weakness of the limbs, numbness of the limbs?

Customer: replied 8 months ago.
Please note answers in my question. No headache or pain some numbness in toes
Expert:  Dr. Muneeb Ali replied 8 months ago.

Yes i did note the answers i just wanted to confirm if you were talking about pain in the neck only or pain anywhere in body including the head. regarding the numbness, i just wanted to confirm no other numbness apart from the possible symptoms of peripheral neuropathy in the toes. That is why i asked those questions and now that you have confirmed these findings i will just compose my answer and get back to you in a few minutes. Thanks for your patience.

Expert:  Dr. Muneeb Ali replied 8 months ago.

The symptoms which you are describing can be due to a number of conditions. The first one which comes to mind is that the pulsations can be due to a problem with the heart. Many a time an irregular rhythm of the heart can present itself as pulsations in the neck. It can also cause symptoms like dizziness, lightheadedness or sweating if it compromises blood flow to the brain however that is not always the case. This is known as an arrhythmia. A simple EKG as well as a echocardiogram followed by a 24 hour holter monitor would be diagnostic in this case.

Now commonly these pulsations can be a conseuqence of anxiety, stress, increased caffeine intake or the side effects of some medications as all of these things can cause the heart to beat faster and more intensely which can lead to the pulsations being felt in the neck. This could also be due to raised blood pressure which could be intermittent. You have mentioned that your blood pressure has always been good and on the lower side but have you checked it after you developed these pulsations? If not then do have it checked when you are having the symptoms, while it is possible that your blood pressure is normal but it would exclude it as a cause definitively.

Now another cause of these pulsations could be because of forceful or torturous flow of blood through the carotid arteries. This can occur in conditions where the lumen of the arteries is narrowed and if this is the case then it would be wise to have this evaluated with a carotid doppler ultrasound of the neck. Infact simply listening to the carotid arteries during a clinical examination can tell us if there is narrowing of the arteries or not. Carotid artery stenosis can occur even if the cholesterol is within normal limits and in many patients with stenosis the cholesterol is found to be within limits.

My suggestion is to get a carotid artery doppler done after a clinical examination IF the pulsations persist for the next week or so or grow more frequent. IF you develop numbness in a whole limb or one side of the body or blurring of vision or weakness of a limb/one side of the body, then that would require immediate medical attention and care.

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