Extreme Anxiety

Hello Everyone, I first want to say that I do not intend to take attention away from anyone with debilitating symptoms and thank you for welcoming me to this forum.

I have an elongated styloid process, but not necessarily Eagle Syndrome. I found this incidentally by taking a picture of my throat with my phone when I thought I might have been getting sick and noticed a bulge in the back of my throat. The bulge was hard to see because it was only visible when moving my jaw a certain way, but reaching back I could feel a bony projection. My primary care physician said they couldn’t feel or see anything, my dentist felt all around and also said he could not feel or see anything. I went to an ENT and at first he said he didn’t notice anything but asking him to feel further back he said “oh that’s your styloid process” and that if I don’t have symptoms to just let it be. I was fine with what he said, and even happy that he acknowledged me, but for some reason recently it is freaking me out.

I am terrified that I have vascular involvement and may not know it, or that it may develop. I’m scared I might turn my head too fast and dissect my artery or have a stroke. This has been causing me anxiety and sometimes heart palpitations, which makes me go in circles of - Do I just have anxiety that’s causing me to over think this or is this bone actually causing these anxiety symptoms? I messaged my ENT to ask if there was a way to check and he told me that he had never heard of the styloids interacting with the carotid artery, which a basic google search would show you that it can. He said we could do a CT scan to reassure me, but that he felt it would not make any actionable changes.

I started to think back about certain things and was wondering if they may be related or if I am just overthinking:

About me: 28 year old Female. Tonsillectomy at 8 years old.

  • 15yrs old - passed out (it was hot outside and I just stood up after sitting)
  • In-frequent lightheaded and/or dizzy (I always associated it with dehydration/not enough food/heat)
  • The other day - I gave a presentation at school and was quite nervous. After beginning my talk the hearing in my left ear just went out and I was afraid I would pass out, but 20-30 seconds later it was fine and back to normal.

I’ve made an appointment with Dr. Rui Fernandes as I live in Florida and saw him on the Doctors List. I’m hoping talking to him might help ease some anxiety but I’m worried this is excessive because I don’t have symptoms and that he may brush me off and me traveling to see him might be pointless.

This has been consuming all of my thoughts, just knowing its there and the possibility of it harming me. Any advice or opinions are greatly appreciated.

Thank you.

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Hi Emily9067!

Welcome to our wonderful forum! I’m sorry you’ve been diagnosed w/ ES & glad your symptoms have been mild.

Here are a couple of links to posts made by Jules, one of our moderators. They should help answer many of your questions about symptoms -

The vagus nerve is often irritated by (an) elongated styloid(s). It is the most expansive of our cranial nerves & affects many body functions including heart rate, blood pressure, gastrointestinal function, voice, breathing, & anxiety. There’s a series on YouTube called Two Minute Neuroscience. Watching the video for the vagus nerve will give you some good info as well.

It does sound to me like you may be somewhat symptomatic due to your styloid elongation. It would be unusual for a person whose styloid is actually visible & palpable in his/her throat to be asymptomatic.

I hope this helps. I expect other members will respond with more information.

:blush:

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Hi Emily,

Welcome. I suggest taking up the ENT’s offer and get a CT scan with and without contrast before seeing Dr. Rui so they can be reviewed with him at your appointment. Sometimes that is half the battle with many ES patients as many docs don’t believe in ES and wont even order the scan to evaluate it further. CT is the “GOLD” standard for diagnosing Eagles. We can help you evaluate the report before your appt and know what to expect or ask the right questions.

FYI: It is not uncommon for ES patients to have this ringing in ears or loss of hearing like you describe.

As Isaiah indicated, elongated styloids can affect the vagus nerve which can cause dizziness and affect other nervous system components (heat related) however given your age when you first passed out and the other symptoms and the associated anxiety and heart palpitations, I suggest you get an evaluation for POTS / Dysautonomia. POTS is postural orthostatic tachycardia syndrome. You primary care doc or even a nurse can check this out easily:
A real simple way to get a general idea about this is blood pressure and heart rate

  1. after laying down 10 minutes,
  2. after sitting upright 10 minutes, and
  3. most important standing for 10 minutes. This is most important to wait 10 minutes before doing heart rate and blood pressure.
    If your heart rate goes up more than 30-40bpm once you stand up, that is a sign of POTS. Often you do not need to stand up for 10 minutes before the heart rate jumps. It is common when there is tachycardia, it presents as “anxiety” because your heart is truly racing but unless someone checks this. If they don’t know and blow it off to anxiety.

This very well may be the vagus nerve causing the recent stuff but some of your early symptoms such as passing out in heated conditions was a red flag for me. Often POTS can rear its ugly head in girls around ages 12-15. My daughter has POTS and started passing out at age 7. The pediatrician called it vasovagel response (vagus nerve) and was normal for it to happen to kids some times. NOT! For several years we learned that she was heat intolerant and could not stand for long periods in heated conditions. IE: passed out waiting in line at water park. Passed out after running in PE, passed out after riding a bike when it was hot out. The heat was the key and the exercise while it was hot out. Within a year of puberty, POTS can worsen and it did with my daughter. She has learned thru the years to read the signs of a “passing out” and prevents them by sitting or laying down. This may very well be vagus nerve irritation from elongated styloids but this is worth checking out given your past dizziness, heat intolerance and feeling like you are going to pass out. Checking your heart rate while standing after sitting is soooo simple. My daughter went undiagnosed for 7 years because no one thought to do this. If you dont see a heart rate jump, you can be confident in ruling that out and the possibility the styloids causing some vagus nerve irritation.
Get that CT scan. Take a breath and dont jump to conclusions just yet about anything. Gather your data first. I hope that helps

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A good idea to get a CT done before you see Dr Fernandes, as Snapple suggests, and one with contrast would hopefully show blood vessel involvement. Hopefully he can put your mind at rest. Surgery can be tricky & would need careful thought about, it’s the only ‘cure’ for ES.

Welcome, and never worry about “taking attention” from someone else. We have plenty of attention to go around here! Everyone else has given you really good advice. The only thing I would add is that there are a LOT of us who have been walking around for years with diagnosed cases of Eagle compressing blood vessels. And as far as I know, not one of us has ever dissected an artery or had a stroke because of it. The odds are WAY in your favor!!!

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I saw Dr. Bunnell who works with Dr. Rui Fernandes. I had a CT scan with contrast done by my ENT on the west coast that I took to the appointment with Dr. Bunnell. Dr. Bunnell did a panoramic X-ray in his office during my initial consult and you could clearly see my elongated styloid (spike) in the panoramic X-ray. Then I had surgery at UF Health (aka Shands) in Jacksonville, FL with a good outcome and pain relief. I hope your appointment goes well and you get relief soon.

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good to know about these doctors in Fl.

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Good to hear from you, emma! I hope you’re getting some answers & making some progress toward feeling better. :heart: :pray:

The dizziness and loss of hearing actually does kind of sound like vascular Eagles to me. I was the same way I thought I just had low blood pressure or something. I’ve had that happen where it feels like all the air is sucked out my one ear and comes out the other ear and I feel like I can’t hear. Hard to describe, but it’s kind of like a sucking sensation in my head. My dizziness symptoms are a lot worse in heat.

My symptoms were manageable for years until they weren’t. I had some lightheadedness etc that was diagnosed as anxiety and also migraine headaches. Now I also have throat problems and that’s what initially sent me to the doctor, I hadn’t connected everything else. It may be worth seeking a second opinion from one of the doctors on the list if you’re worried.

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