Hello,

Thanks for posting your query.

I understand your concern.

Please do not worry as the chances of brain tumour being missed on MRI and neurological evaluation are highly unlikely.

Though I do agree with you that the symptoms could be indicative of some inner ear problem more likely than just being a manifestation of depression. The symptoms of pain, vertigo, tinnitus and ear fullness can be most probably seen in inner ear or labyrinthine disorders like meneieres disease, acoustic neuroma etc.

It sounds as though you could have Menier's disease which can be missed on routine imaging and investigations, and there are clinical tests specific to this (especially an electronystagmogram, which helps at least to confirm a problem with the equilibrium system involving the eyes and ears). If you haven't had this test performed, I would specifically ask for it. An otolaryngologist, neurologist, or ENT specialist could order the test and the results might hopefully reveal something all the other tests have not.

Another possibility to be considered is TIA (transient ischemic attack), since you had the MRI done one year before you developed this new phenomenon, there is a possibility of a silent stroke in the area concerned with equilibrium and auditory functions. In this case, a repeat MRI of the brain would be of most value along with a repeat neurological examination.

I hope you have been examined by an Ear nose throat specialist or otolaryngologist , if yes do discuss this possibility with him, if not please do consult one before you give up on further investigation.

I would also advise you to take a multivitamin supplement especially including vitamin-B complex, as its deficiency can be a common cause of neuropathic problem like pain and parasthesias (tingling numbness).

Also if all further work up does not show any pathology please consult a therapist to rule out a psychosomatic illness like anxiety or depression before you start medications for the same as sometimes counselling and behaviour therapy are as useful as medications.

Hope I have answered all your queries. I will be available for further follow-up.

Wishing you a speedy recovery.

Regards.

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Hello,

Thanks for the follow up.

Please do not worry. TIA(Transient ischemic attack) does mean a minor stroke like condition but a reversible one and if your investigations turn out to be normal it may not even be the possible cause.
So do not add to your stress but do discuss it with your doctor.

Your doctor is right in suggesting the work up for thyroid and echo doppler of supra aortic vessels.
That may reveal any vascular insufficiency causing ischemia of the head face neck region supply.
Although I still do feel that any significant or devastating cause is less likely.

Hope that answers your query

Regards

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