Unilateral Tinnitus, Dizziness, and Head Numbness Symptoms

Q: Unilateral Tinnitus, Dizziness, and Head Numbness Symptoms

Hello Mr. <br>Hsu： You mentioned that "your left ear started to feel a bit stuffy, followed by the onset of tinnitus, and occasionally experiencing brief episodes of dizziness while walking." May I ask what your blood pressure is? Do you have any issues with hypertension, hyperli

Unilateral tinnitus + dizziness + paresthesia of the head?

Hello Doctor,
1.
On the evening of August 22, 2022, I began to feel a slight pressure in my left ear, followed by the onset of tinnitus.
While walking, I occasionally experienced brief episodes of dizziness (similar to a sensation of the world swaying up and down), but I felt fine while sitting.

2.
By August 25, 2022, the dizziness had resolved, but I continued to experience unilateral tinnitus, although it was less intense.

3.
On August 29, 2022, around noon, I experienced dizziness again while walking, and the tinnitus became louder.

4.
After a night’s sleep on August 30, 2022, my condition did not improve, so I visited an otolaryngologist.
They conducted a hearing test and performed a tympanometry, both of which were normal.
The doctor also examined my eyes for nystagmus and asked me to walk with my eyes closed and bend down to pick something up, but no abnormalities were found (for example, I did not lean to one side or experience vertigo when bending).
The doctor concluded that I did not have any significant issues and suggested that my symptoms might be due to stress or muscle tension, prescribing Lexotan 3mg to be taken once daily.

5.
On August 31, 2022, the dizziness began to occur more frequently, and I started to experience occasional dizziness even while sitting.
Additionally, I began to feel a brief tingling sensation in my head.
The tinnitus sounds like a continuous high-pitched "E" tone.

I would like to ask if my symptoms are simply due to stress and muscle tension, or if I should consider undergoing further examinations.
Thank you.

Xu, 30~39 year old female. Ask Date: 2022/08/31

Dr. Jiang Junyi reply Neurology

Hello Mr.
Hsu: You mentioned that "your left ear started to feel a bit stuffy, followed by the onset of tinnitus, and occasionally experiencing brief episodes of dizziness while walking." May I ask what your blood pressure is? Do you have any issues with hypertension, hyperlipidemia, or diabetes? Given the sudden onset of tinnitus along with dizziness, we should first rule out eustachian tube dysfunction.
Additionally, we should consider whether there is inadequate blood circulation or nerve inflammation.
For nerve repair, it is recommended to supplement with B vitamins and manage risk factors.
Thank you for your inquiry, and I suggest you consult with a neurologist and an otolaryngologist for further evaluation and treatment.
Wishing you good health and peace.

Reply Date: 2022/08/31

More Info

Based on your description of symptoms, it seems you are experiencing a combination of unilateral tinnitus, dizziness, and occasional head numbness. These symptoms can be quite distressing and may indicate underlying issues that warrant further investigation.

Tinnitus, or ringing in the ears, can often be associated with various conditions, including ear infections, exposure to loud noises, or even stress and anxiety. The fact that your tinnitus is unilateral (affecting only one ear) is particularly noteworthy. This can sometimes suggest issues related to the inner ear or auditory nerve. Dizziness, especially when it occurs with changes in position or movement, can be indicative of vestibular dysfunction, which involves the inner ear structures responsible for balance.

The timeline of your symptoms is also significant. You mentioned that the onset of your ear fullness and tinnitus began in August 2022, followed by episodes of dizziness. The fact that your dizziness worsened and became more frequent, even while sitting, suggests that it may not solely be related to muscle tension or stress, as initially suggested by your ENT doctor. While stress and anxiety can exacerbate symptoms, they are not typically the sole cause of persistent dizziness and unilateral tinnitus.

Given that your hearing tests and physical examinations did not reveal any immediate abnormalities, it may be beneficial to consider additional evaluations. A few potential areas to explore include:
1. Vestibular Testing: This can help assess the function of your inner ear and balance system. Tests such as videonystagmography (VNG) or rotary chair testing can provide insights into whether there is a vestibular disorder contributing to your symptoms.

2. Imaging Studies: An MRI or CT scan of the head may be warranted to rule out any structural issues, such as tumors or abnormalities affecting the auditory nerve or inner ear.

3. Neurological Evaluation: Since you mentioned experiencing head numbness, it may be worthwhile to consult a neurologist. They can assess for any neurological conditions that might be causing your symptoms.

4. Stress and Anxiety Management: While it is essential to rule out physical causes, addressing stress and anxiety through therapy, relaxation techniques, or medication (as prescribed) can also be beneficial in managing your symptoms.

5. Physical Therapy: If your dizziness is related to vestibular dysfunction, vestibular rehabilitation therapy (VRT) may help improve your balance and reduce dizziness.

In conclusion, while your symptoms may be influenced by stress and muscle tension, the persistence and nature of your symptoms suggest that further evaluation is warranted. It is essential to communicate your concerns with your healthcare provider and advocate for additional testing if you feel your symptoms are not improving. Early diagnosis and intervention can lead to better management of your condition and improve your quality of life.

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