Differential Diagnosis for Loud Noise at Night in Head
- Single most likely diagnosis
- Tinnitus: This is the most common diagnosis for a loud noise in the head, especially at night when it's quieter and more noticeable. Tinnitus is often described as a ringing, buzzing, or hissing sound in the ears when no external source of the sound is present.
- Other Likely diagnoses
- Earwax impaction: Sometimes, a buildup of earwax can cause sounds that might be perceived as loud noises in the head, especially if the wax is close to the eardrum.
- Middle ear infection or Eustachian tube dysfunction: Infections or dysfunction in the middle ear can lead to unusual sounds or sensations, including loud noises.
- Otosclerosis: A condition where there's abnormal bone growth in the middle ear, which can cause hearing loss and might lead to the perception of loud noises.
- Meniere's disease: Although primarily known for vertigo, tinnitus is a common symptom, and the noise could be perceived as louder at night.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acoustic neuroma: A rare, benign tumor on the nerve connecting the inner ear to the brain. It can cause tinnitus, among other symptoms, and is crucial to diagnose early.
- Temporal lobe seizures: Rarely, seizures originating in the temporal lobe can cause auditory hallucinations, including loud noises.
- Vasculitis or vascular malformations: Conditions affecting blood vessels can sometimes cause tinnitus or unusual sounds due to altered blood flow.
- Rare diagnoses
- Palatal myoclonus: A rare condition that can cause a clicking sound in the ear due to muscle spasms in the palate.
- Patulous Eustachian tube: A condition where the Eustachian tube stays open, allowing sounds from the throat to be heard in the ear, potentially perceived as loud noises.
- Superior canal dehiscence syndrome: A rare condition where there's an abnormal opening in the bone overlying the superior canal of the inner ear, leading to a variety of auditory and balance symptoms.