Hi Dr.,
I was recently notified by my neurologist that I have disk herniations on my lumbar spine (I had an MRI).
I don't think they're severe, but I've been having more minor pain recently in my lumbar spine. I have also been having PE recently. My next appointment with my neurologist in on April 10th, but I'm concerned now that the PE is somehow related to the disk herniations and some nerve issues.
I decided to go to a sports medicine orthopedist and to the neurologist because I was getting a numb right leg after about 1 mile of running. After running a mile my leg would feel sort of dead; this would wear off after about five minutes of not running.
Anyway, I have no history of PE. I've always been able to last a while and have good about my performance. In fact, I'm on Lamictal, the mood stabilizer, and on Emsam. Emsam, my doctor says, actually delays orgasm, which has been my experience. So now, I don't really know what's going on.
Any ideas as to what might be happening?
The symptoms of tinnitus can be controlled by various methods. The correlation between tinnitus, temperomandibular joint disorder and neck muscle contraction is not well understood. Also tinnitus may not be present round the clock. Such tinnitus could be due to TMJ or fistula or due to vestibular disorders or due to postural hypotension etc. At times the cause is neuro-vascular. Neck muscle contractions regulate the blood flow to certain blood vessels. This could be the reason behind your ability to stop the sound. However, the exact mechanism is more complex than that. Please consult a senior ENT specialist. You may need specialized test like CBCT or a 3D CT Scan. I am sorry, but this cannot be assessed on net. Also high jugular bulb may be a differential diagnosis, but though benign, it may or may not be the cause in your case--and yes, if you had that, you may be able to control your symptoms by contracting your neck muscles. Please consult a good ENT specialist and get all neurological tests, angiogram, specialized imaging and audiology testing done, without which I am sorry, but no diagnosis can be reached.
If it's a high jugular bulb.. Is that benign? And if I had that would that give symptoms suddenly?
And how comes it's better sometimes and the worse in the morning in your opinion?
Hope you can answer my last questions
Thanks. But I guess if it was a fistula then I would hear it always.
I don't hear any whooshing normally .only if I spasm my left neck muscles. For example when I bend over I hear on a certain point a whoosh. This is a one time rush sound. If bend over and put my left arm high as well. And if turn my neck to the right while bending forward which spasms my scm muscle. But if I squees my scm muscle then it stops. It simply stops.
I can modulate it by jaw movements as well. Not only pressing the jaw
But when I bend over and
Any sound that is being conducted through the bones will reduce if you close your ears or press on the jaw joint or on the temporal bone area etc. So, yes, a sound from a fistula can reduce a lot if you press anywhere that hampers the bone conduction of sound. However, this does not diagnose or rule out fistula.
Eustachian tube disorder is a possibility and usually responds to valsalva maneuver (take a deep breath and blow while pinching your nostrils shut and closing your mouth). This will help clear the secretions in the tube that connects the back of your throat with your ear. Normally the normal hearing is restored with a pop sound.
It is very difficult to give a definite opinion on net without a detailed clinical examination. So, it is important to look at all possibilities including benign intracranial hypertension. Please discuss with your doctor.
What about Eustachian tube disorder?
Hello,
Thank you. I asked in fact what you thought it might be.. But in fact you mentioned all possible reasons which I already see on all Internet pages.
But according to my symptoms I was hoping to have an opinion.
About fluid in ear, I mentiond I visited gps and ETN so sure they looked for that. And no there is no fluid.
So if the sound was from a fistula then it would stop if I close my ear? Or if there is an increase blood flow ?
Hi!
Yes, the symptoms do appear to be very confusing. Pulsatile tinnitus is a possibility. It does not always occur due to fistulas. The most common cause of pulsatile tinnitus is noisy blood flow as blood pushes through plaques or kinks in the arteries in the head or neck. It can be made worse if there is also hypertension. An angiogram is required to rule this out.
Several types of fistulas in the blood vessels of head and neck, especially the carotid artery or jugular vein can also cause this—so this cause would have been ruled out by MRA.
Increased blood flow as seen in anemia and hyperthyroid state can also cause pulsatile tinnitus. So this should be looked into. Fluid in middle ear can be another cause—this may have been ruled out by your ENT. However, usually such sounds disappear when you close the ear—so please ask your doctor to again look into this.
Vascular tumors of middle ear such as glomus tumors or paragangliomas or vascular tumors of temporal bone can also cause this -- this may have been ruled out by your ENT, however please re-check.
Another possibility is benign intracranial hypertension. You may need a spinal tap to rule this out. This may or may not present with any other symptom except tinnitus, and though this isolated presentation may not be common, it is worth looking into. Please consult your doctor regarding this.
Hope you are tinnitus free soon! Good Luck and take care!
I just consider that if Trigger it and hear it and I close my ear with my finger then it is less or it disappear