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Left platysma contraction

07/17/2006

Question:

My symptoms started with an earache, something I had never had in my life. Antibiotics were administered w/o success. There were/are no visible signs “wrong” with the ear. Then symptoms progressed to facial pain, a falling down feeling on the left side of my face, there were sharp ear pains at the beginning and then they extended to the top of my head which continues to feel bruised though to the naked eye it is not. MRI/CT were done showing only some deterioration around the cervical area and a “fibrous substance” that seemed to affect the TM disc from transversing laterally. It was thought, since I could not open my mouth very wide, that there was no gag reflex on my left side and that there is definite lack of muscle tone with my tongue (which also feels bruised to the touch)that perhaps I have TMJD. TMJD was ruled out by a well known doctor and expert in the study of TMJD. He did conclude that now, 4 years later there is some evidence that whatever this originally was is also causing some pain and deterioration in that area. Still, during these four years symptoms have continued to reveal themselves and include, dysarthria, problems at times in swallowing, on occassion a need to what sounds (and is) a gasp of air, hiccups that went on for days and then diminished,rigidity over all of the body,facial contraction pulling the mouth up and to the left, platysma contraction (constant)and visible swelling (1 MRI revealing fluid 2 years ago)in the supraclavicle area. I can tell you from the very beginning that with the ear pain, which felt as if you had stuck a Qtip into the ear too far, I felt that on the left side of my neck an area that felt like it was the center of all the pulling sensation, etc. On a poster in a neurologist office I saw that area and in it is located a bundle of nerves. Tracing and reading what the nerves affected I told the neurologist as soon as he came into the office, pointing to the area, that area was where I had felt most of the pulling and I could see by the graph that what that bundle of nerves affected were also related to my symptoms. I`ve been diagnosed with Dystonia with possible hemi Parkinson`s. Still a recent face scan showed an asymmetry of the left side of the neck. A follow up MRI did not reveal any mass but only more cervical deterioration. Still, the platysma contraction is evident in looking at me as is the swelling around the subclavicle area. Now a neurologist has decided that since he can not find anything himself that I have a somatization disorder – other doctors, including psychiatrists, disagree. What disease of the ear area could over time cause these symptoms to occur and should I go back to an ENT specialist? Please help me. I must add that when I use the heal of my palm to press my ear(I do this sometimes because of the pain in that area, including the facial pain) I can hear fluid and sometimes after doing this there is a very small amount of clear fluid that comes out that I can feel with my little finger. I do take sinemet which has helped in my trouble walking but still there are times that my balance is off. The trouble with all of these symptoms is that they are not always apparent when I have my doctors appointment excepting the platysma contraction, the loss of muscle tone in my tongue and the evident swelling around the supraclavicle area. Thank you for reading this and I anxiously wait your response.

Answer:

You have a very long and complicated history.  I would recommend evaluation by a neuro-otologist (an ear specialist).  He may then suggest you consult another neurologist for a 2nd opinion.  Your symptoms sound more like a neurological disorder rather than a psychiatric one.

For more information:

Go to the Ear, Nose, and Throat Disorders health topic.