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.
Do you have any more questions?
Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,