Recurring Dizziness and Facial Pain: ENT Insights

Dizziness and facial pain?

Hello Doctor: I have been experiencing recurrent dizziness for about three years, particularly discomfort and occasional pain in the back of my neck.
Each episode lasts approximately two weeks and is accompanied by a general feeling of warmth and night sweats.
Two years ago, while using the computer, I suddenly felt a heavy pain on the upper left side of my head, followed by intense pain in my entire cheek, neck, and chest, making it difficult to breathe.
However, it resolved within a few seconds.
Since then, I have been experiencing pain and tenderness behind both ears and below them.
Sometimes, I also feel tooth pain when eating, and there is tenderness along the edges of my cheeks.
The area of my neck near my cheeks often feels tight and occasionally painful.

In recent months, after recurrent colds, I have had persistent sore throat symptoms that have not improved for over two months.
My voice has gradually become hoarse, and I have frequently experienced nasal congestion and loss of smell, which lasts all day.
I have also had nighttime coughing for several years, and recently, I have been coughing continuously.
Previously, I noticed blood-tinged mucus in my nose upon waking up, but this has only happened three times.
Now, I feel strange sensations above my shoulders, like pain and dizziness, along with a sense of swelling.

I previously consulted an ENT specialist, who examined my ears and found no issues, although I have a history of recurrent ear infections.
My thyroid was also deemed normal.
However, these problems persist, and I am unsure what this could indicate or which specialist I should consult for accurate diagnosis and treatment.

abe, 30~39 year old female. Ask Date: 2012/04/10

Dr. Xu Yingzhuo reply Otolaryngology

It is difficult to determine; a medical center should be consulted for professional testing.

Reply Date: 2012/04/10

More Info

Hello,
Based on your detailed description of recurring dizziness, facial pain, and other associated symptoms, it seems you are experiencing a complex set of issues that may involve multiple systems in your body. Here’s a breakdown of your symptoms and some potential avenues for diagnosis and treatment.

Symptoms Overview
1. Recurring Dizziness: This could be related to vestibular issues, cervical spine problems, or even migraines. Dizziness can arise from inner ear disorders, neck issues, or even anxiety.

2. Facial Pain and Pressure: The pain in your face, particularly around the cheeks and jaw, could suggest a condition like trigeminal neuralgia or sinusitis. The fact that you experience pain when eating may indicate involvement of the temporomandibular joint (TMJ) or dental issues.

3. Neck Discomfort: Pain and tightness in the neck can often be linked to muscle tension, cervical spine disorders, or referred pain from other areas.

4. Throat Pain and Hoarseness: Persistent throat pain and hoarseness, especially after recurrent colds, could indicate chronic laryngitis or even gastroesophageal reflux disease (GERD), which can cause throat irritation.

5. Nasal Symptoms: The nasal congestion and loss of smell you describe could be due to chronic sinusitis or allergic rhinitis. The presence of blood in nasal discharge, although infrequent, should be monitored.

Potential Conditions
Given the combination of your symptoms, several conditions could be at play:
- Chronic Sinusitis: This could explain your nasal congestion, facial pain, and throat discomfort. Sinus infections can lead to referred pain in the face and neck.

- Cervical Spondylosis: Age-related wear and tear on the cervical spine can lead to neck pain, dizziness, and headaches.

- Migraine-Associated Vertigo: Migraines can cause dizziness and facial pain, often accompanied by other neurological symptoms.

- Temporomandibular Joint Disorder (TMJ): This could explain the facial pain, especially if you have any jaw clenching or grinding habits.

- Trigeminal Neuralgia: Characterized by sudden, severe facial pain, this condition could be triggered by various stimuli, including eating.

Recommended Steps
1. Consult an ENT Specialist: Since you have ongoing throat and nasal symptoms, an ENT (Ear, Nose, and Throat) specialist can evaluate for sinusitis, throat issues, or other ENT-related conditions.

2. Neurological Evaluation: Given your dizziness and facial pain, a consultation with a neurologist may be beneficial. They can assess for migraine disorders, cervical spine issues, or other neurological conditions.

3. Physical Therapy: If cervical spine issues are suspected, physical therapy may help alleviate neck pain and improve mobility, which could also reduce dizziness.

4. Dental Evaluation: If TMJ disorder is suspected, a dentist specializing in jaw disorders can provide insights and treatment options.

5. Allergy Testing: If allergies are suspected to be contributing to your nasal symptoms, allergy testing may help identify triggers.

Conclusion
Your symptoms are multifaceted and may require a multidisciplinary approach for effective management. It’s essential to communicate all your symptoms clearly to your healthcare providers to ensure a comprehensive evaluation. Keep a symptom diary to track when symptoms occur and any potential triggers, which can be helpful for your doctors in diagnosing your condition.
Please ensure you seek medical attention promptly, especially if your symptoms worsen or new symptoms arise. Your health is paramount, and addressing these issues early can lead to better outcomes.

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