Differential Diagnosis for Pulsation or Palpitation Inside the Left Ear

Single Most Likely Diagnosis

• Benign Intracranial Hypertension (BIH) or Idiopathic Intracranial Hypertension (IIH): This condition can cause pulsatile tinnitus, which is the perception of a rhythmic sound (like a heartbeat) in the ear, often due to increased intracranial pressure. The pulsation or palpitation sensation inside the ear can be a symptom of this condition.

Other Likely Diagnoses

• Carotid Artery Stenosis or Atherosclerosis: Narrowing or hardening of the carotid artery can lead to turbulent blood flow, which might be perceived as a pulsation or palpitation in the ear.
• Anemia: Reduced hemoglobin or red blood cell count can increase blood flow velocity, potentially causing a pulsatile sensation in the ears.
• Thyroid Disorders (Hyperthyroidism): An overactive thyroid gland can increase heart rate and blood flow, leading to sensations of pulsation or palpitations, including in the ears.
• Eustachian Tube Dysfunction: Problems with the tube that connects the middle ear to the back of the nose and throat can lead to sensations of fullness or pulsation in the ear.

Do Not Miss Diagnoses

• Giant Cell Arteritis: Inflammation of the arteries, particularly those in the head, can lead to serious complications like blindness if not promptly treated. While less common, it's crucial to consider due to its potential severity.
• Aortic Aneurysm or Dissection: Although rare, an aneurysm or dissection of the aorta can cause pulsatile symptoms and is a medical emergency.
• Glomus Jugulare Tumor: A rare, benign tumor in the jugular vein can cause pulsatile tinnitus due to its proximity to the ear and its effect on blood flow.

Rare Diagnoses

• Vascular Malformations (e.g., Arteriovenous Malformations): Abnormal connections between arteries and veins can cause a variety of symptoms, including pulsatile sensations in the ear, though they are relatively rare.
• Paget's Disease of Bone: A condition that affects bone remodeling can lead to vascular and neurological symptoms, including pulsatile tinnitus, especially if the bones of the skull are involved.
• Otosclerosis: A form of bone growth in the middle ear that can cause hearing loss and, in some cases, pulsatile tinnitus, though it's less commonly associated with a palpitation sensation inside the ear.