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Knocking in ear and head, off balance, arm weakness, no nausea, pins and needles. Worried about brain tumor

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
In December 2011 (last year) I awoke because I had a strange 'knocking' noise in my right ear or head (?) - after this I have not felt well - I have head pains in right side of head and feel constantly off balance not exactly dizzy but as though I am being pulled or pushed especially on my head and I feel momentary weakness in my arms - I have discomfort in my right ear and I don't know whether this is of any importance but round my right ear when I open my mouth I can hear a sort of cracking noise but my jaw does not hurt. The knocking noise only occurs in the evening and when I am in bed. I have no nausea. The pains in my head scare me and are most of the time at the back or sometimes just above right ear. I also get sometimes pins and needles in my left foot and a sort of pins and needly feeling on my scalp. My doc just wants to treat me for depression as he said I saw a neurologist in Dec 2010 and had and MRI scan although he didn't think I needed either and they came back clear. I saw another doc and he gave me blood tests and something showed up on thyroid so I am now awaiting further tests I presume to see if i have over active under active thyroid. I also had slight blood in urine but he didn't seem too concerned. I am so worried convinced I have a brain tumour or something terrible
Posted Mon, 16 Apr 2012 in Brain and Spine
Answered by Dr. Hema Yadav 3 hours later

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.

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Follow-up: Knocking in ear and head, off balance, arm weakness, no nausea, pins and needles. Worried about brain tumor 39 hours later
Thank you for your reply - do these trasient ischenmic attacks mean I am having small strokes or likely to have a devesatating one? I am so worried and my head feels so odd - my doc is also testing for thyroid as that reading came back to be investigated - also he suggests an echo-doppler of gthe supra-aortic vessesls - i feel so miserable
Answered by Dr. Hema Yadav 6 hours later

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

Above answer was peer-reviewed by
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