Left Ear Ringing, Dizziness, and Facial Numbness: When to Seek Brain Imaging?

Tinnitus in the left ear, dizziness, and left-sided facial numbness?

I usually have symptoms of chronic rhinitis, such as sneezing and post-nasal drip.
Recently, I have experienced prolonged tinnitus in my left ear that hasn't improved, and I have also started to feel numbness in the left corner of my mouth and dizziness.
Should I undergo a brain examination?

Xiao Taiyang, 30~39 year old female. Ask Date: 2022/11/17

Dr. Peng Shiwei reply Neurology

Based on your symptoms, it is recommended that you consult a neurologist.

Reply Date: 2022/11/17

More Info

When experiencing symptoms such as persistent left ear ringing (tinnitus), dizziness, and facial numbness, it is crucial to evaluate the situation carefully and consider seeking medical attention, particularly brain imaging. These symptoms can indicate a range of underlying conditions, some of which may require prompt diagnosis and treatment.

Symptoms Overview
1. Tinnitus: This is the perception of noise or ringing in the ears, which can be caused by various factors, including exposure to loud noises, ear infections, or even neurological issues.

2. Dizziness: This can manifest as a feeling of lightheadedness, unsteadiness, or vertigo. Dizziness can arise from inner ear problems, vestibular disorders, or central nervous system issues.

3. Facial Numbness: Numbness or weakness in the face, particularly if it affects one side, can be a sign of neurological conditions, including stroke or multiple sclerosis.

When to Seek Brain Imaging
Given your symptoms, it is advisable to seek brain imaging, such as an MRI or CT scan, especially if:
- The symptoms are new and have developed suddenly.

- There is a significant change in your usual health status.

- You experience additional symptoms such as severe headaches, vision changes, difficulty speaking, or weakness in other parts of the body.

Potential Causes
1. Vestibular Disorders: Conditions affecting the inner ear can lead to dizziness and tinnitus. An example is Meniere's disease, which can also cause hearing loss.

2. Neurological Issues: Conditions such as multiple sclerosis, transient ischemic attacks (TIAs), or strokes can present with facial numbness and dizziness. These conditions may necessitate immediate imaging to rule out serious complications.

3. Sinus Issues: Chronic sinusitis or nasal congestion can sometimes lead to ear problems, including pressure and tinnitus. However, the presence of facial numbness raises concern for more serious conditions.

4. Infections: Viral infections affecting the ear or central nervous system can also lead to these symptoms.

Imaging Techniques
- MRI (Magnetic Resonance Imaging): This is particularly useful for visualizing soft tissues, including the brain and inner ear structures. It can help identify tumors, lesions, or other abnormalities that may be causing your symptoms.

- CT (Computed Tomography) Scan: This is often used to quickly assess for acute issues, such as bleeding or significant structural abnormalities in the brain.

Conclusion
In summary, given your symptoms of left ear ringing, dizziness, and facial numbness, it is prudent to consult a healthcare professional for a thorough evaluation. They may recommend brain imaging to rule out serious conditions. Early diagnosis is key to effective treatment, especially if neurological issues are involved. If you experience any worsening of symptoms or new symptoms, seek immediate medical attention.

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