Pulsatile Tinnitus with Daily Ear Pain

Hello, I'm new here. My one sided pulsatile tinnitus symptoms started in March just before lockdown so have not made any progress with investigations.

I have been referred for brain MRI and hearing test.

I am not troubled by the noise (I have had non-pulsatile bilateral tinnitus for nearly 3 years), but with the pulsatile tinnitus there is also ear pain. Daily but not constant.

Any suggestions as to what the cause could be?

Grateful for any replies. Thank you.

 

@Mint64 During times with ear pain with pulsatile tinnitus, problem may be moments of having higher than normal blood pressure and with that the nerves within the ears often take notice.

Moments, even brief incidents of high blood pressure from anxiety or tension can cause pulsatile tinnitus.

If you are over 50 years old, atherosclerosis is often caused by high blood pressure. With that when a very high blood pressure moment happens from stress, plaque from an artery’s inner lining (called the endothelium) can becomes damaged - or plaque can become loose and travel to the carotid artery or internal jugular vein.

MRA is much better than a MRI for neck and head exam with pulsatile tinnitus.

Controlling blood pressure is important. One may have normal blood pressure 99.9 percent of the time. It's moments when blood pressure raises considerably that can cause pulsatile tinnitus.

I would research how to control blood pressure and look for suggestions (non medication) that might help you.

If you feel that you may have moments of higher than normal blood pressure from stress, I can give you suggestions to help control.

Magnesium Glycinate will lower blood pressure by 12%. Use that's needed is 1/3 tablet three times a day with also taking 1/3 tablet of Vitamin C.

Blood pressure medications for some can increase tinnitus and pulsatile tinnitus, so that's needs more discussion. I would need to provide study links about this.

 

Thank you for your reply Greg. I realise that the problem could be arterial but so far have not found much information on pulsatile tinnitus with pain. Hadn't considered high blood pressure as I am actually a long-term user of beta blockers as a migraine preventative.

Apart from the pulse and other noise (pumping, whirring, spinning and vibration - like a washing machine) I also hear an intermittent squeak in my ear. It is not wax, I have had microsuction recently). There is also brief dizziness when I lie down as in BPPV.

 

Mint, can you give the name of your beta blocker. I also added a little more to my post above.

 

Thank you Greg. I take propranolol 160mg slow release daily as a migraine preventative.

 

Basically, micro suction, caused movement of calcium crystals into your ear canals. BPPV should disappear. BPPV can be more evident, with blood pressure that goes up and down as in too low at times. Propranolol needs to be taken at the same time each day.
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Propranolol for some, can increase tinnitus. It should help to control pulsatile tinnitus, but not a jugular blub problem which is a cause of pulsatile tinnitus in one ear. There has been a few reports where propranolol has caused a jugular blub problem. I really doubt a jugular blub problem, but a MRA on neck and another at a later date on head will show what is going on. Angiograms are best. Ironically this test could do damage to arteries and veins, but that is rare.

 

Thank you again Greg. I expect that the microsuction explains the BPPV. I had no idea. Am hoping that investigations will eventually explain the pulsatile tinnitus.

 

@Mint64 You have a kind soul and I thank you.

Please stay in touch.

You may only need a medication adjustment for blood pressure.
Maybe buy a blood pressure monitor to see it your pressure is high or low.
Then place the numbers - example - BP 130/90 - into an internet search and sites with this reading will appear and discuss the reading.

Ask your doctor if a change from a MRI to MRA is possible.
An MRA is a test that lets your doctor see inside your blood vessels -- your arteries and veins. MRA stands for Magnetic Resonance Angiogram or MR Angiography.

Wear ear plugs.

 

Just an update. I had my MRI a little over a week ago and have not yet been informed of the result. I have a hearing test tomorrow. I am meant to have an MRA but do not yet have an appointment. It is over a month since I first posted and in that time the left ear pain has worsened. It is on and off throughout the day every day from shortly after waking. Interested to see that someone else is experiencing ear pain with pulsatile tinnitus.

 

Hi, I have ear pain and PT. Ear pain is intermittent and short but it can be intense. I don't have BPPV or hearing loss and optic nerves are good according to routine eye exam. I had an MRI today so I will come back and let you know the results next week when they are received. x

 

Thank you.

My hearing test was normal but still waiting for MRA appointment. Won't get result of MRI until consultant is ready to review me, and that won't be until after I have had the MRA.

My PT actually stopped some weeks ago but the ear pain has since increased. Intermittent and brief - like yours. I still have chirping and buzzing and high pitched ringing. The ringing I have had for 3 years.

The BPPV has stopped.

 

An update.

All my investigations were normal: MRA head and neck blood vessels, MRI brain, MRI ear, hearing test.

I still have the same symptoms of pulsatile and non-pulsatile tinnitus and a throbbing ear pain that comes and goes throughout the day. Have been discharged without diagnosis.

I was offered a referral to a hearing clinic for help with coping with the noise but I declined this as I am habitualized to it. Pain management referral was also suggested but the pain is only mild so I declined this as well. Told that pain could be neuropathic. But it started at the same time as the pulsatile tinnitus.

Will just have to wait and see.

Thank you again to those who offered advice.