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pulsatile tinnitus
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pulsatile tinnitus

In July  of 2002 (6 months after 2nd son born) I woke up in the middle of the night and could hear my heartbeat in my right ear then i started getting dizzy and the right side of my face bacame numb and tingled.  I went to my GP , he sent me to hospital for CAT scan . I was then prescribed ammoxicillin.The dizziness is gone MOST of the time.  A few months later I was referred to an ENT, he has been VERY helpful and understanding; however, I still do not have any definite answers and my general health ( sense of well-being) has only worsened.  

Symptoms:  Extremely loud pulsatile tinnitus in right ear (and I can now slightly hear it in my left ear as well), seven sinus infections in 7 months, severe pain in right shoulder, elbow and wrist, pain in lumbar region of back including fatty tumors, pain in my tail-bone that makes sitting painful, pain in back of legs and hips. I amy almost always nauseated and throw up at least 3 times a month.  TMJ . Constant tingiling in right leg down to small toe, headaches, Goiter, athsma has worsened.

Tests:  CAT scan of brain(without contrast), MRI of brain(without contrast), MRA of Brain, MRI of cervical spine, MRI of Lumbar spine, Hearing test, Mineriere's disease test, Autoimmune Ear Disease test, Rhumatoid Arthritis test, Thyroid antibody test, allergy test, doppler of corotid arteries, neurological testing, nerve conduction studies of right elbow and wrist, optic nerve photographs, eye pressure testing for benign intercranial hypertension.

Specialists seen and treatments;  

Dentist, checked TMJ said was moderate but was not cause of pulsatile tinnitus or headaches.

Othopedic surgeon, sent me to neurologist for nerve conduction study (normal) then gave me a cortizone injection near radial nerve elbow was relieved for three months, then recurred, had another injection did not help, suggested a RA test, told him I had a normal test result.  Tried Mobic, vioxx, clelbrex, no relief. Next appt June 26th. spinal tap next scheduled test.

Neurologist, (ENT referred)  corotid doppler test, done yesterday , prescribed trazadone for tingles in face and headaches(said maybe miagraines), take 3 before bed no relief but still taking.

ENT, tests for RA, Autoimmune ear disease, thyroid levels, thyroid antibody, mineres, hearing, allergy test , prescribed valium 5mg 3 x day (helps some dealing with the noise), vicoprofin for PAINS (helps alot but does not completely relieve  the pain sill hurts in elbow wrist, hips, legs, and low back. 3 times daily) Has referred me to ENT surgeon in Chapel Hill to MOVE VEINS FROM ABOVE EAR to BELOW EAR relieve noise from pulse. Appt. is 7/17/03.

MEDS provential, advair, vailum, vicoprofin, trazadol, welbutrin
AGE 32
BP 100/70
Pulse 88
WT 139
HT 5'51/2"
Cholesterol 130
non-smoker
light drinker.

Any insight or suggestions please, should i see a rhumatologist?  I feel like I am crazy or hypochrondriac, I just want some help and to feel good again. Thank you so much for your time.
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Hello - thanks for asking your question.

As you have seen several specialists and undergone a very comprehensive evaluation, what I can offer here (without examining you) will be limited.  However, I have a few thoughts.

You have undergone MRI's and CT scans that were non-revealing.  Positron emission tomography (PET) has been able to pick up abnormal blood flow in the auditory cortex in animal tinnitus models and is used experimentally in humans in the evaluation of tinnitus.  Furthermore, single photon emission tomography (SPECT) imaging may be more clinically useful. SPECT imaging shows not only dynamic changes within the brain at the neurotransmitter level, but can sometimes be more sensitive than conventional brain imaging (CT scan, MRI or MR angiography) in identifying an anatomic or vascular anomaly.  These are tests you may want to discuss with your specialists.

As for treatments, you have tried many medications.  Masking and tinnitus retraining therapies (TRT) can be discussed with your ENT.  Masking devices resemble hearing aids and are designed to produce low-level sound that can reduce and in some cases eliminate the perception of tinnitus.

Biofeedback, acupuncture and electrical stimulation have also been tried with varying success.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.
1 Comment
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Avatar_n_tn
I have pul. tinnitus. Did you have an ultrasound of the neck? The MRI you had was it to check the carotid artery?
My ENT tested for that right away.  Good luck. I know the noise will drive you crazy but I have blocked it out. I heard the ear aide really works. Good luck
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Avatar_n_tn
I have that same sound too and have had it for at least 6 years. I've been to a neurologist who told me he hears that sound all the time in OLDER patients. I'm 50. He saw I had the carotid atery scan, MRI of the head and neck and an MRA of the brain and dismissed it as being "idiopathic". Said I might have a kink in the carotid artery, said there is nothing he could do and sent me home. I went to a head and neck surgeon who wanted to immediately hospitalize me for an angiogram. Said that he thought I have an av-malformation in the neck that he claims might not show up in those other tests. My HMO didn't want to pay for the angiogram, said the other tests were enough as they found nothing in those.So I still hear the heartbeat sound all the time in my left ear. Not so bad during the day with background noise but at night when it's quiet is another story. I've learned to deal with it though. I have had some bouts with headaches that I've never had before that center on that one side of my head and also have had some bouts with vertigo. My new physician thinks that enough tests have been done and doesn't want to pursue it anymore. It's a shame that we can't find out what is causing this and have to get passed on to so many doctors. I don't have all the symptoms you do but have had this for a while now. Good luck, if you have found anything else out please post it here. The other comments by the dr were interesting but no likely my dr will order those tests he talked about or even my HMO wanting to pay for them.
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Avatar_n_tn
I have that same sound too and have had it for at least 6 years. I've been to a neurologist who told me he hears that sound all the time in OLDER patients. I'm 50. He saw I had the carotid atery scan, MRI of the head and neck and an MRA of the brain and dismissed it as being "idiopathic". Said I might have a kink in the carotid artery, said there is nothing he could do and sent me home. I went to a head and neck surgeon who wanted to immediately hospitalize me for an angiogram. Said that he thought I have an av-malformation in the neck that he claims might not show up in those other tests. My HMO didn't want to pay for the angiogram, said the other tests were enough as they found nothing in those.So I still hear the heartbeat sound all the time in my left ear. Not so bad during the day with background noise but at night when it's quiet is another story. I've learned to deal with it though. I have had some bouts with headaches that I've never had before that center on that one side of my head and also have had some bouts with vertigo. My new physician thinks that enough tests have been done and doesn't want to pursue it anymore. It's a shame that we can't find out what is causing this and have to get passed on to so many doctors. I don't have all the symptoms you do but have had this for a while now. Good luck, if you have found anything else out please post it here. The other comments by the dr were interesting but no likely my dr will order those tests he talked about or even my HMO wanting to pay for them.
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A related discussion, pulsitile tinnitus and facial neuropathies, bells palsy was started.
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