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Stabbing pains in temples, short sudden episodes, loud pulsating sound in left ear. On BP medication. Causes for headache?

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Practicing since : 2001
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Thank you for your service. I have for a number of years suffered from a sharp stabbing pain in my left temple which lasts for only approximately 10 to 20 seconds. I have to stop what I am doing and just hold my head and feel very tired afterwards. (sometimes I seem to see in the negative for a few seconds). They only occurs infrequently and without any warning. I am 65 yr old female. I am generally healthy but am on blood-pressure medication and having a constant loud pulsating in my left ear/neck.
Posted Sun, 22 Apr 2012 in Headache and Migraines
Answered by Dr. Shiva Kumar R 27 minutes later

Thanks for the query.

From the information provided it looks like you may have two issues - one is neuralgic pain over the left side of face along with a pulsatile tinnitus. Features of neuralgic pain suggest the possibility of Trigeminal Neuralgia and require medications for control of the pain. Carbamazepine or Gabapentin would be a good option.

Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow or increased blood turbulence near the ear. Rarely, pulsatile tinnitus may be a symptom of potentially life-threatening conditions such as carotid artery aneurysm or carotid artery dissection. Pulsatile tinnitus may also indicate vasculitis, or more specifically, giant cell arteritis and Idiopathic intracranial hypertension.

So I personally feel a good clinical examination and consultation with an ENT surgeon and Neurologist is essential at this point of time to exclude more serious problems. MRI of the brain and neck along with blood work up would be required as a part of the investigation.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.

Dr Shiva Kumar R
Neurologist & Epileptologist
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