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Dr. Andrew Rynne

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What headache with ringing in ear,jaw pain and double vision?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2561 Questions

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Posted on Mon, 25 Aug 2014 in Ear, Nose and Throat Problems
Question: For over 8 weeks I have had a number if symptoms in my head - throbbing electrical-type pain in back of head, right ear ringing, behind both eyes are very sore (not double vision but at times eyes are unfocused and sore to move them around), right side of face and neck is sore both above and below ear, vein above ear feels swollen and pulsating, ache in jaw when chewing, arms are weak and sore. I also have very low appetite and have lost approx 18 pounds. In the past few days my appetite has been a bit better. I am also extremely fatigued. I had a negative head and neck MRI AND CT scan. My SED AND CRP is normal, I was told that it wasn't Polymyalgia Rheumatica or Giant Cell Arteritis because of the SED test and my age. I have had some other standard blood work done, which was ok too (platelet count a touch high but has been before). My ophthalmologist has looked at my eyes twice so far and can't see anything. I was also checked out by the cardiac centre because my pulse has been high and was having chest pain occasionally along with arm pain. Heart was fine. I have a bit of plaque in carotid arteries - found through Doppler ultrasound. I have large gallstones and have had issues with that lately too. I am wondering what it can be and what else I can do?
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Answered by Dr. Sumit Bhatti 3 hours later
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for your query.

1. As many causes of such symptoms have been ruled out, causes that can lead to symptoms in the head neck region and the arms will be centered around the cervical spine, skull base including blood pressures and supply (carotid plaque).

2. It would be worthwhile re-examining your MRI, CT images and clinical examination notes. The list of possible causes is long, however here are a few observations.

3. At your age, Sleep Apnea and Peri-Menopause symptoms (fatigue, appetite issues and weight loss) may also be involved.

4. The electrical throbbing pain is likely to be a neuralgia. The ringing in the ears need hearing tests of the ears to be done before attributing it to other causes. Sore eyes may be due to transient sinusitis or dryness in the eyes. Intra-ocular and Intra-cranial pressure should be checked. Pulsating vessels may be due to blood pressure fluctuations or turbulent blood flow. Ear discomfort may be a referred sensation. Pain in the jaw may be a Trigeminal Neuralgia or a Temporo-Mandibular Joint Syndrome.

If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumit Bhatti 5 hours later
Thanks for the response. I had a full hearing test a month ago which was normal. My intra-ocular pressure has always been high 25-26 at highest. I am followed by an Ophthalmogist regularly because of this. How would i have intra-cranial pressure checked? The carotid plaque I was told is less than 50%. Would i be able to get the MRItest results on disk and attach them for your review?
doctor
Answered by Dr. Sumit Bhatti 29 hours later
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. Raised intra-cranial pressure will cause changes in the fundus of the eye in a few weeks and so does chronic hypertension.

2. The carotid block is mild to moderate in severity. Is it on the right side?

3. You may upload the MRI Scan and send a link via a free file sharing site.

If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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