Pulsating Sensation in the Left Occipital Region

Twitching of the muscles near the left ear and occipital region?

Hello Doctor, since last Friday night, I have been experiencing a pulsating sensation in the left side of my occiput (just above the left side).
It feels similar to an eyelid twitch, but now it is in the back of my head.
I have noticed that the pulsating sensation becomes more pronounced whenever I clench my left teeth, which made me wonder if it could be related to dental cavities.
I went to the dentist on the fourth day, but the dentist said that my cavities are only on the surface of the teeth and should not be significantly related to the pulsation.
The pulsating sensation in the left occiput becomes more noticeable when I clench my left teeth or when I sleep on my left side at night.
Since this is somewhat bothersome, I would like to ask the doctor if I need to see a neurologist for this condition.
Has anyone else experienced similar symptoms before?

Xiao Jie, 20~29 year old female. Ask Date: 2021/06/16

Dr. Jiang Junyi reply Neurology

Hello Ms.
Hsiao-Chieh,
In this era where everyone uses electronic devices, such issues are relatively common.
The most common cause of muscle spasms in the left cervical region is nerve root compression in the cervical spine, leading to muscle tension.
Prolonged periods of looking down can cause overuse of the trapezius muscle in the back of the neck, resulting in neck and shoulder pain.
Initially, resting may alleviate the pain, but eventually, it can worsen and affect daily activities.
Some patients experience severe neck pain upon waking, characterized by stiffness, tightness, and unbearable pain.
I recommend the following:
1.
Change Positions: Change your posture every 15 minutes to allow the neck tissues to rest.
Maintaining any posture (including normal ones) for an extended period can lead to tissue fatigue and inflammation, so moving around briefly can reduce the risk of muscle inflammation.
2.
Rest: Resting allows the muscles to utilize their self-repair capabilities.
During this time, avoid vigorous activities.
3.
Neck Heat Therapy: Apply heat for 15 to 20 minutes, ensuring the temperature is safe to avoid burns.
4.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): For individuals without a history of peptic ulcers, allergies to NSAIDs, or normal kidney function, consider using NSAIDs as needed to reduce inflammation and alleviate pain.
5.
Neck Muscle Stretching Exercises: After the acute pain phase, develop a habit of performing slow and gentle neck stretches every 15 to 20 minutes, ensuring the angles do not cause discomfort.

I suggest consulting with a neurologist or a rehabilitation physician for further evaluation and treatment.
However, due to the recent COVID-19 pandemic, it is advisable to wait until the situation stabilizes before visiting a hospital for examination.

Please implement self-protection measures before and after your medical visits, including cleaning and disinfection, and adhere to new pandemic prevention practices.
Thank you for your inquiry, and feel free to discuss any related questions!
Wishing you good health and peace,
Dr.
Jiang Jun-Yi, Taoyuan Medical Center

Reply Date: 2021/06/16

More Info

The pulsating sensation you are experiencing in the left occipital region can be concerning, especially since it is accompanied by an increase in intensity when you clench your teeth or lie on your left side. While I cannot provide a definitive diagnosis without a physical examination, I can offer some insights into potential causes and considerations based on your symptoms.

Firstly, the sensation of pulsation in the occipital area may be related to muscle spasms or tension in the surrounding muscles. The occipital region is home to several muscles, including the sternocleidomastoid and the trapezius, which can become tense due to stress, poor posture, or prolonged periods of sitting or lying in one position. This tension can lead to a sensation similar to what you describe, especially if it is exacerbated by clenching your teeth, which may indicate a relationship with bruxism (teeth grinding) or jaw clenching.

Additionally, the fact that the pulsating sensation increases when you bite down could suggest that the temporomandibular joint (TMJ) is involved. The TMJ connects your jawbone to your skull and can be affected by various factors, including dental issues, stress, and muscle tension. If the joint is inflamed or if there is muscle tension in the area, it could lead to referred sensations in the occipital region.

Another possibility to consider is that the pulsating sensation could be related to nerve irritation or compression. The greater occipital nerve, which supplies sensation to the back of the head, can become irritated due to various reasons, including muscle tension or cervical spine issues. If the nerve is compressed or irritated, it may cause sensations that feel like pulsations or twitching.

Given that you have already consulted with a dentist who ruled out significant dental issues, it may be beneficial to consult a neurologist or a physician specializing in headaches or musculoskeletal disorders. They can perform a thorough evaluation, which may include a physical examination, a review of your medical history, and possibly imaging studies if deemed necessary. This will help to rule out any underlying neurological conditions or structural issues that may be contributing to your symptoms.

In the meantime, consider implementing some self-care strategies to alleviate tension in the neck and head. These may include practicing relaxation techniques, such as deep breathing or meditation, engaging in gentle neck stretches, and applying heat or cold packs to the affected area. Additionally, if you suspect bruxism, you might want to discuss the possibility of a night guard with your dentist to help protect your teeth and reduce jaw tension.

In summary, while the pulsating sensation in your left occipital region may be related to muscle tension, TMJ issues, or nerve irritation, it is essential to consult with a healthcare professional for a comprehensive evaluation. They can provide you with a more accurate diagnosis and appropriate treatment options tailored to your specific situation. If your symptoms persist or worsen, do not hesitate to seek medical attention.

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