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What Could Be The Cause Of Severe Dizziness, Numbness Of Right Side Of Face, Painful Ear And Blurred Vision ?

Posted on Tue, 8 May 2012

Question: Hi I am a 42 year old female, I am about 5 10" and about 10.5 stone. Problems began with severe dizziness, numbness of right side of face and a full painful ear, visually it seems as if I am looking at the world through a goldfish bowl, things appear quite surreal and I am physically exhausted. This began suddenly about 9 months ago and culminated in extreme anxiety due to these persistent symptoms. I am trying to deal with the anxiety (med free) but the ear symptoms persist. I find myself having to cough up lots of thick clear mucus which collects at the back of my throat. My ear and jaw are painful and when I open my mouth my ears make a strange clicking noise with a little more mucus. I cannot get a doctor to take me seriously - they just hear the word 'anxiety' and them attribute everything down to this but the anxiety came after ... not before the difficulties. I did have an MRI on my ears which came back fine ... also they have looked inside my ears but to no avail. Help please as I feel unable to cope with this

Answered by Dr. Dr. Naveen Kumar Nanjasetty (5 hours later)

Hi

Thanks for the query

The symptoms you have described in the history could be due to multiple problems associated.

1. My ear and jaw are painful and when I open my mouth my ears make a strange clicking noise with a little more mucus.
These symptoms could be due to cough up lots of thick clear mucus which collects at the back of my throat.
Chronic sinusitis can lead to excess mucus production, associated with the cough due to trickling of the secretions inside the throat.

The combination of the above two conditions can give rise to dizziness also. It would be wise to get a CT scan of the paranasal sinuses to rule out sinusitis followed by appropriate medications. Do steam inhalation 2-3 times/day, drink plenty of warm water and take mucolytics to reduce the thick nasal secretions.

For the temporomandibular joint disorder, you need to avoid chewing food on the affected side, avoid hard food, use pain relieving gel over the affected joint and take oral anti-inflammatory medicines (such as ibuprofen or diclofenac).

Hope I have answered your query, if you have any more doubts you are welcome.

Regards
Dr. Naveen Kumar
ENT and Head & Surgeon

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (10 hours later)

Thank you for your response, I had wondered about TMJ but due to the build up of mucus, I had dismissed this as an option. My jaw clicks on both sides, the clicking is not painful, just noisy. It seems that the jaw pain is running under the jaw on the ear affected side. I have been steaming with menthol a couple of times each day for the last 4 months but to no avail. The ear pain is predominantly in the right ear, it feels very painful, hot and full but my nose seems clear and there is no facial pressure, could this still be sinus issues? Furthermore, the mucus seems mostly to collect on the side of the ear fullness. I had a CT scan about 9 months ago when this all started and it came back clear, is it still worth suggesting to have another? Also, and this is probably not connected but maybe worth a mention, I also have a pain on the lower left rib in one very small area, very strange as this began with all the initial symptoms, I though perhaps I had just knocked into something, but still it persists. Any further advice would be appreciated. Does my anxiety exacerbate these conditions - it seems a long and extremely exhausting cycle and everyday is very difficult from me, I want to get past this but dont know how.

Answered by Dr. Dr. Naveen Kumar Nanjasetty (2 hours later)

Hi,

Welcome back

Second part of your history does steer towards a different diagnosis. As I had mentioned in my previous post that you are suffering from multiple problems, it needs a thorough evaluation before making any conclusions. If you feel the pain could not be due to TMJ dysfunction then the other possible causes could be either ‘Eagle’s syndrome’ or ‘Trigeminal neuralgia’.

In Eagle’s syndrome there is elongation of the styloid process causing unilateral sore throat, dysphagia, tinnitus, unilateral facial and neck pain, and otalgia. In patients with the vascular form of "Eagle syndrome", the elongated styloid process is in contact with the extracranial internal carotid artery. This can cause a compression (while turning the head) leading to sudden bout of dizziness.

Trigeminal Neuralgia is a neuropathic disorder characterized by episodes of intense pain in the face, originating from the trigeminal nerve. Pain worsens on chewing, talking, exposure to wind, etc.

With respect to the mucous production, a repeat CT scan would be definitely helpful. In case of the normal CT result, then the only other cause of mucous production would be the acid reflux disease.

To sum it up, you require a thorough evaluation by a team of ENT and Neurologists. Avoid anxiety as it is one of the contributing factors for your problem.

Wish you good health

Regards
Dr. Naveen Kumar
ENT and Head & Neck Surgeon

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar