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What Causes Intense Pressure Behind The Nose While Suffering From Pheochromocytoma?
Question: Hi, my name is XXXX and I'm suffering from an overproduction of Epinephrine. I am taking 5htp to bring these levels down and I am weaning myself off of Clonazepam after taking .375mg everyday for 6 months (doctors tried this to lower my epinephrine levels). I have been monitored (MRI with contrast) every year for the past 3 years for a very small pituitary lesion which has not grown. As I am getting on the 5htp and getting off the Clonazepam, I have noticed a strange sensation of pressure behind my nose that most closely feels like the pressure you get right before you sneeze, or the sensation you get when you get water up your nose. It comes and goes, but I typically feel it for a half second right before I get these strange sensations of epinephrin through my body which causes my heart to beat faster. I recently had an MRI to check my pituitary and it showed that the pituitary appeared normal, but I was told that to "rule anything out" I'd have to come back to have it done with contrast. For reasons I won't go into here, the contrast is very bothersome to my system and I can't have it. My question to you is... if there was something VERY WRONG that was causing me to feel this pressure behind my nose, would a plain MRI (without contast) be enough to pick that up? They said the regular MRI is normal, unremarkablel. Would a regular MRI pickup on something that needed to be addressed right away?
Brief Answer:
The MRI you have done is enough.
Detailed Answer:
Hello,
Thank you for asking on HCM!
I have gone carefully through your report.
It would be better to explain your concern more specifically. What do you feel exactly, how long does it last and since when do you have with this ''sneeze'' sensation?
MRI images with contrast are clearer than the images of MRI without contrast. Due to the high clarity of images gathered by MRI with contrast, they are easier for a medical specialist to evaluate and interpret.
In your case (The strangulation feeling) I would advice to check the serum calcium level rather than a MRI.
Please do not hesitate to ask for further suggestions.
Kind Regards,
Dr.Mirjeta
The MRI you have done is enough.
Detailed Answer:
Hello,
Thank you for asking on HCM!
I have gone carefully through your report.
It would be better to explain your concern more specifically. What do you feel exactly, how long does it last and since when do you have with this ''sneeze'' sensation?
MRI images with contrast are clearer than the images of MRI without contrast. Due to the high clarity of images gathered by MRI with contrast, they are easier for a medical specialist to evaluate and interpret.
In your case (The strangulation feeling) I would advice to check the serum calcium level rather than a MRI.
Please do not hesitate to ask for further suggestions.
Kind Regards,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
It is a vague sensation that there is pressure behind my nose. I get these sporadic "hot flashes" where I feel a nasal pressure that is followed by a feeling of adrenaline that runs through my body causing my heart to race for a few moments. This got worse when I started to wean myself off of Klonopin and started taking 5htp.
I am interested to followup with a contrast MRI but not for a few months. I just wanted to make sure that IN THE MEANWHILE if something were majorly wrong, such as a pituitary tumor pressing on my nasal cavity, that a NON-CONTRAST MRI would have picked that up, as I had that done 2 months ago while I was having this issue and it showed nothing.
I am interested to followup with a contrast MRI but not for a few months. I just wanted to make sure that IN THE MEANWHILE if something were majorly wrong, such as a pituitary tumor pressing on my nasal cavity, that a NON-CONTRAST MRI would have picked that up, as I had that done 2 months ago while I was having this issue and it showed nothing.
Brief Answer:
See below;
Detailed Answer:
Welcome back,
I think the feeling of the pressure you have behind the nose is due to a vasodilation that happens in those moments and causes the palpitations and hot flushes too.
Do not worry about the pituitary mass, it should be a huge mass to cause such pressure in the nose and MRI would have revealed it for sure.
I would recommend to check the blood pressure at that particular moment and the heart rate.
If the high level of catecholamines is confirmed before, well your treating physician should try to find out the cause. A pheochromocytoma should be excluded in these cases.
An MRI of the adrenal glands is suggested in cases where high catecholamines is confirmed.
Hope I have been helpful.
Kind regards,
Dr.Mirjeta
See below;
Detailed Answer:
Welcome back,
I think the feeling of the pressure you have behind the nose is due to a vasodilation that happens in those moments and causes the palpitations and hot flushes too.
Do not worry about the pituitary mass, it should be a huge mass to cause such pressure in the nose and MRI would have revealed it for sure.
I would recommend to check the blood pressure at that particular moment and the heart rate.
If the high level of catecholamines is confirmed before, well your treating physician should try to find out the cause. A pheochromocytoma should be excluded in these cases.
An MRI of the adrenal glands is suggested in cases where high catecholamines is confirmed.
Hope I have been helpful.
Kind regards,
Dr.Mirjeta
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Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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