Pulsating Head Sensations: When to See a Neurologist

The head may feel pulsating?

Hello doctor, I started experiencing ear fullness about a month ago, followed by tinnitus.
The noise from the tinnitus is really loud, and I can only sleep until around two or three in the morning.
Then I began to have dizziness with a sensation of spinning, ear pain, and a feeling of numbness and pressure in my head.
Initially, it was just in the front of my head, but recently it has spread to the back.
In the past few days, I've also felt a pulsating sensation in my head; at first, it lasted only a few minutes and wasn't painful, but it has become more frequent and somewhat painful over the last two days.
When I look at things, it feels like they are pulsating with my head.
At night, I also experience a cool sensation with chest tightness and a bit of nausea.
When I move my eyes, I can hear a ringing sound in my ears, and my hands also tremble (a nearby clinic said this is related to poor sleep).
I would like to know if I need to see a neurologist, which specialist I should consult.
What could be causing the pulsating sensation in my head? Thank you!

Niming, 20~29 year old female. Ask Date: 2017/11/01

Dr. Jiang Junyi reply Neurology

Based on your description, your dizziness symptoms may suggest Meniere's disease, which is characterized by recurrent episodes of vertigo accompanied by tinnitus or hearing loss.
During episodes, resting and using some antihistamine anti-vertigo medications along with anxiolytics can be quite effective in alleviating symptoms.
As for the headaches and nystagmus you mentioned, these may indicate issues related to the neck or brainstem.
It is advisable to consult a neurologist for further evaluation and treatment.
If you are looking for a specialist, it would be prudent to first see a vascular neurologist to rule out any vascular lesions.
Wishing you good health and peace.

Reply Date: 2017/11/01

More Info

Based on your description of symptoms, it sounds like you are experiencing a complex array of neurological issues that warrant a thorough evaluation by a neurologist. The symptoms you mentioned, including pulsating sensations in your head, ear ringing (tinnitus), dizziness, and feelings of numbness or tingling, can be indicative of several underlying conditions.
Pulsating sensations in the head can sometimes be associated with vascular issues, such as migraines or tension-type headaches. Migraines can present with a variety of symptoms, including throbbing pain, sensitivity to light and sound, and sometimes even aura symptoms, which can include visual disturbances or sensory changes. Tension-type headaches, on the other hand, are often characterized by a feeling of tightness or pressure around the head and can be exacerbated by stress or muscle tension in the neck and shoulders.

The presence of tinnitus and dizziness suggests that there may be involvement of the auditory system or vestibular system. Conditions such as Meniere's disease, vestibular migraines, or even issues related to the cervical spine can lead to these symptoms. Meniere's disease, for example, is characterized by episodes of vertigo, tinnitus, and hearing loss, and it can significantly impact quality of life.

The numbness and tingling sensations you are experiencing, particularly if they are spreading from the forehead to the back of the head, could be related to nerve irritation or compression. This could be due to muscle tension, cervical spine issues, or even neurological conditions such as multiple sclerosis, which can cause sensory disturbances.

Given the complexity and variety of your symptoms, it is crucial to seek a neurologist who specializes in headaches or neuro-otology (the study of neurological conditions affecting the ear and balance). These specialists will be better equipped to evaluate your symptoms in the context of potential neurological disorders. They may recommend imaging studies, such as an MRI or CT scan, to rule out structural abnormalities in the brain or cervical spine that could be contributing to your symptoms.

In addition to seeking medical advice, there are some self-care strategies you might consider to help manage your symptoms. Stress management techniques, such as mindfulness meditation, yoga, or gentle exercise, can help reduce muscle tension and improve overall well-being. Ensuring that you maintain a regular sleep schedule and avoid caffeine or other stimulants, especially close to bedtime, may also help alleviate some of your symptoms.

It is important to keep a detailed record of your symptoms, including when they occur, their duration, and any potential triggers. This information can be invaluable to your healthcare provider in making an accurate diagnosis and developing an effective treatment plan.

In summary, your symptoms are concerning and warrant a thorough evaluation by a neurologist, preferably one with expertise in headaches and vestibular disorders. Early intervention can lead to better management of your symptoms and improve your quality of life. Don't hesitate to seek help, as timely diagnosis and treatment are key in addressing neurological issues effectively.

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