Woke Up with Pulsatile Tinnitus — Other Symptoms: Dizziness, Balance Issues, Face Numbness, and More

Hi everyone!

My pulsatile tinnitus started the first week of January 2021 and I've been having a rough time with it as most of you can imagine. Here is my story. I'm male, 46, exercise daily, could use to lose a few pounds but in generally good health. I don't know if all this is related but here is how I got here. I have fairly bad seasonal allergies and 2020 was a particularly bad year. In July of 2020 I started experiencing balance and dizziness issues followed shortly by vertigo. The vertigo was pretty bad. To the point that if I moved my head to the right or lay on my right side everything would spin. Late July I saw my Family Doctor who looked me over and diagnosed me with Benign Positional Vertigo which made sense since it happens with the movement of my head in a certain direction.

At the same time he suggested I start on blood pressure medication due to being pre-hypertensive for a couple of years. My blood pressure would normally run 125-135/84-94 depending on the time of day or how stressed I was at the time. Since it tends to be on the higher side when at the doctors, he had me start Amlodipine 5mg for a month. At the monthly check up there was no change in blood pressure and I was still dealing with dizziness, balance issues and vertigo that came and went. However, I now developed stuffiness and pain in my right ear. Looking in my ear he saw nothing but added 7mg of Perindopril to my Amlodipine for the blood pressure. Another month goes by and my blood pressure has dropped slightly but I'm still dealing with the balance, dizziness, vertigo and ear stuffiness and pain issues. Doctor looks me over and says Benign Positional Vertigo can take weeks to months to clear up and sends me on my way.

The next few months were tough dealing with the side effects of the blood pressure and my other symptoms. Come December and my right ear is plugged, aching, crackling when I yawn or chew and now I'm feeling pressure in the right side of my head and right side sinuses. Back to the doctor's I go and he checks my ears and says everything is clear and send me on my way suggesting I try some decongestant for a week. It didn't help.

January arrives and this is when everything comes to a head. Dizziness, loss of balance, vertigo (less frequent but there), right ear pain, pressure, muffled sounds, sinuses plugged, pain behind the right eye and the right side of my head is numb (not paralysis but that tingly pins and needles feeling you get before you hand or arm falls asleep), AND I wake up with that famous pulsating whoosh whoosh in my ear. That's when I tossed my blood pressure medications aside (couldn't handle their side effects) and I up my decongestant take. I start Nasonex and Claritin D every morning for a week and it did help with the pain behind my eye and all the side effects of the blood pressure medicine were instantly gone! But the pulsatile tinnitus continued and is now driving me insane. I can't sleep, concentrate and I'm nauseous all the time. If that wasn't bad enough, my entire field of vision also shakes ever so slightly in sync with my heart beat and every whoosh of my pulsatile tinnitus. I deal with this for 4 weeks and in February, back to the doctor's I go.

I describe what has been going on, what I've tried and he looks at me like I have three heads! He takes another look in my ears and sees nothing and suggests getting me in to see and ENT as soon as possible. This was on February 11th. He says I'll be hearing from the ENT's office in the next week or so. Come February 13th, my pulsatile tinnitus, vision, face numbness, dizziness and balance was so bad the wife takes me to the ER. Full blood work done, urinalysis, and a CT scan with contrast on my head and neck was immediately done. Blood work came back perfect, urinalysis perfect, CT scan with contrast perfect! No aneurysms, no dissection, no hydrocephalus and all structures are where they should be. Blood pressure was at 145/95 but the nurse or doctor were not concerned about that considering what I've been dealing with. This all gave me some reassurance but the ER doctor was still concerned with my symptoms that he spoke with a neurologist and they decided to put me on a low dose daily Aspirin once a day until they get me in for an MRI for a better look.

Let me tell you, it's been a rough few months but when the pulsatile tinnitus started my anxiety and depression has been through the roof! I try and take comfort that the CT scan with contrast didn't show anything ominous but the loud pulsatile tinnitus, lack of sleep and concentration issues has impacted my daily life. I have stated using ear plugs when I sleep and although it does lessen the drone of the pulsatile tinnitus, I can still hear the sound of what I can only describe as blood whooshing behind my ear. My vision still shakes (only noticeable when I'm sitting still) and I'm still dealing with the dizziness and balance issues.

Not hearing back from the ENT or Neurologist is weighing on my stress but I will be following up with them by the end of this week. I will provide updates as much as possible. I appreciate everyone on this forum and all who have read through my entire post. I'm happy that I've found others that pulsatile tinnitus has affected who can understand the agony that it is. If anyone has questions please ask or share you experiences, whether the same as mine or not and I hope your pulsatile tinnitus is short lived and resolved!

Regards!

D

 

@SilenceIsBliss, I would step up your medical care and see an interventional radiologist that specializes in pulsatile tinnitus. From everything that you mention hypertension blood pressure from previously having normal low may have directed to your carotid arteries. All it takes is a sudden and brief episode of rising blood pressure above 145/95 to bring plaque from other vessels and organs to your carotid arteries.

Hypertension can also narrow arteries and most common is carotid arteries.
Atherosclerosis can cause hypertension and hypertension can cause atherosclerosis.

With a 145/95 reading, very possible that you had an episode(s) where your blood pressure went higher. I would at least get ultrasound of your carotid arteries.

I can give you so many links about this. Or research hypertension blood pressure - hypertension crisis (eyes) - carotid artery.

 

Hi Greg,

Thanks for the reply. Any links or feedback you can supply would be greatly appreciated. As most people on here, I've been googling every possible scenario and it's got my anxiety through the roof!

I'm hoping to get in to see the Neurologist and ENT specialists this week and will seek to have my Carotid arteries looked at a little closer. I'm hoping to eliminate all the really scary stuff that pulsatile tinnitus can be caused from first and work my way down.

 

Patients with systemic arterial hypertension may have cochlear dysfunction associated with vascular disease because of hypertension, but hypertension doesn't cause BPPV.

Are your glucose levels and lipoids borderline? Having BPPV may cause hypertension from what we both discussed including stress. Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo, but hypertension from having BPPV may have brought on your pulsatile tinnitus. It may be that your family has a history of BPPV and maybe hypertension. As you mention, BPPV should resolve within weeks or months.

Getting to the source of your pulsatile tinnitus is best now, than later. Calcium channel blockers may help, but use of central agonists may also help if arteries of neck (carotids) are not narrowed by more than >50%. Your mentions point to carotids, but something else may be going on. To add, dizziness, vertigo, eye pain, ear pain and abdominal pain are symptoms that accompanies a hypertensive crisis or high blood pressure.

 

Greg:

Thanks for the input. I have an appointment with a neurologist in a few days and a otolaryngologists the following week. I'll be sure the neurologist focuses on the carotids and anything else he may think is significant. The pulsatile tinnitus is very troubling. I deal with it better some days and terribly the next. It really doesn't weigh in you both mentally and physically. The vertigo has subsided but the pain behind the ear, side of head and eye is still there. Dizziness and balance are still an issue as well. You would think I was drunk at times when I walk lol. I'm not a doctor but I don't think it is BP related and the attending physician at the hospital wasn't too concerned either even though it was elevated when I was there. I track my pressure 3 times a day. Off meds for 6 weeks and the average is 126/86. The way it progressed and symptoms I'm having, I'm thinking inner ear issues.

Regardless, I'm going to get to the bottom of it and post up my findings.

 

Curious about any updates.

 

Hi AliasM,

I have seen a neurologist and otolaryngologist. Both on physical examination have not come up with anything. They have me scheduled for an MRI, MRA and an ultrasound of the carotid arteries. The pressure and pain in my right ear has gotten better as has the numbness on the side of my head and my balance issues. I'm hoping it's all linked to an eustachian tube infection/dysfunction. The pulsatile tinnitus is still there but seems lower in tone at times than before. Further tests begin this week and I will update as results come in.

 

Hi SilenceIsBliss,

I've been following your thread, and wanted to chime in to say I have virtually identical symptoms as you've described. It's uncanny really.

I've already had the MRI (nothing abnormal) but am now scheduled for the MRA in a few weeks.

Wishing you all the best in your upcoming tests, and very interested in reading any further updates as you're able to post them. Somehow, we'll find the way through this.

Best,
Phil

 

Hi Phil,

Currently, the pulsatile tinnitus has come down A LOT! At its peak it was debilitating. I would have to wear an earplug to drown out the drone just to get to sleep. The whooshing was so relentless my whole field of vision would pulsate as well. Only if I sat still and focused on something. During the day, I wouldn't notice it. This sent my anxiety and depression through the roof. Good news is, the pulsating vision has stopped completely since the pulsatile tinnitus has come down. I can hear it only when the room is silent or when I go to bed. It's low enough that I don't need an earplug anymore. Only thing I've done in the last few weeks is use Polysporin ear drops with Lidocaine and apply Vicks VapoRub around My ear nightly.

In the last couple of weeks I've had my MRI, ultrasound of the carotid arteries and was sent to a dizziness and balance clinic for a VNG, vHIT, hearing and caloric stimulation test. I have been recalled for the MRI test again in two weeks. When I questioned why a recall? She said it doesn't necessarily mean somethings wrong and I shouldn't worry. During the visit to the dizziness and balance clinic, all tests seemed to go smoothly until the caloric stimulation test. They lay you back in a chair and put a pair of dark goggles on you that have a camera built in to monitor your eye movement. They proceed to blast cold water in your ears for 30 seconds to stimulate a dizziness and nystagmus response. I was nervous cause who wants to deliberately invoke dizziness? She started in the right ear (pulsatile tinnitus side) and I waited for the dizziness but not much happened. She came around to the left ear and after the 30 seconds I felt like everything was spinning and I could feel my eyes behind the goggles searching. I said to the technician "well, that sucked" and she said "I'm sorry, we're going to have to do it again with hot water." They got two different responses from my ears and that's not good. She started in the right again. Not much of a response. The left ear, dizziness as it should be. I asked her if it could be from an ear infection that I'm not getting the appropriate response and she said it could be many things from minor to major and the otolaryngologist will have to investigate further. He should have the results by the end of this week. So there's something going on but at least I'm on track to figuring it out.

As for my other symptoms, my balance and dizziness have gotten 100% better. My ear still aches, feels clogged and literally half my head is numb! Pins and needles. Keep in mind, the pulsatile tinnitus was the last symptom to present. That's why I'm hoping for something minor as an inner ear/eustachian tube dysfunction issue that easily manageable but since I've been recalled for the MRI has got me a little worried.

Hopefully you and everyone else that's dealing with this is doing well! I'll update as results come in.

Regards,
D.