New member- Just received ES diagnosis

Hello! I will be possibly going for several tests in the very near future - CTA scan of cervical spine, MRV, barium swallow test, EEG. holter monitor, and Glossopharngeal nerve block. I really don’t think I want to go for the nerve block because I really don’t have pain with swallowing or pain in the mouth. I do experience tightness/ pressure and muscular pain in my lateral neck especially on the right side. Why else would I want to undergo this nerve block?
I’m also wondering if the barium swallow is necessary since I’m really not having problems with swallowing as well. I am curious to find out if the styloid are encroaching on my arteries and veins though. Has anyone ever undergone US testing of the arteries and veins in the neck?
Thanks for your consideration!
P.S. I also have a Chiari 1 malformation of the brain which also causes me a lot of problems!

The CT with contrast will show up any problems with the blood vessels, but yes, some members have had ultrasound scans to see what effects the styloid processes have on their carotid arteries. I’m not an expert, but from memory I think that several members have had swallow tests and I don’t think it often shows anything helpful. Hopefully other members who’ve had that done could chip in!

Thank you so much for your response.

Fortunately you live in PA where there are several good ES surgeons should you elect to have surgery. Dr. Cognetti has probably done the most surgeries. You can find his info in the Doctors’ List (click on the HOME tab above).

Neck pain is what led me to my ES diagnosis. It’s a pretty common symptom. Your right styloid is probably angled such that it’s pressing on & irritating nerves on the right side of your neck. I don’t know much about Chiari 1 Malformation, but as Jules said, if you’re undergoing the tests you listed for further ES diagnosis, all you really need is the CT scan with contrast to see vascular involvement.

Hope this helps.

Thank you for the speedy response. I am glad to know that there are some very good surgeons in PA. My main complaint is neck pain and muscular tightness on the right that can worsen with rotation of my head. There are times where I can feel a little spacey. I am curious what you have done so far in terms your treatment plan. Would you mind sharing your story with me?


I had bilateral ES surgery. My first one was in Nov. 2014 & my second in Aug. 2015. Unlike others on this site, I was diagnosed w/in a couple of months of symptom onset & was told surgery was my only option. I was very blessed to find I live near Dr. Samji who had done more ES surgeries than anyone in the US & perhaps the world so I felt comfortable w/ “jumping in” to surgery. It was the best possible choice I could have made. Healing takes awhile - several months to really get back to normal but the pain relief and ability to return to a more normal lifestyle was so worth the lost time. I think you will find that most people who have ES surgery have this sort of perspective. I know Jules does.

Forgot to say that if you have bilateral ES, the second side often feels more painful after the first side is taken care of. It’s not that it has necessarily gotten worse, it’s just that the pain is more focused on only one side. People & doctors have mistaken this situation to mean that the first surgery was unsuccessful which, in fact, is an error in reasoning.

Thanks for sharing. Curious to see what the tests will show for my case.

Please keep us posted!

I had the Ultrasound both sides of my neck, and then repeated it on one side with my neck rotated and tilted down [trying to mimic my loss of consciousness angle]. I wish they did both sides rotated too. I showed a decline in flow by 58% on the side they tested. This test doesn’t hurt, and gives really good info!

I just had my surgery…feel free to read about my saga on here

Good luck

Thank you for the info on ultrasound and how the head can be placed in various positions for testing. Looking forward to finding out the results of my tests.

I had an ultrasound of my next done last fall. It’s a pretty simple and painless procedure. You need to insure they do a positional ultrasound so that they get readings when your head/neck are in different positions. I get vascular tinitus when my head is bent or turned just right so I was concerned my styloid was pressing on my carotid artery. Test showed no problem but I don’t feel it was conclusive as the tinitus wasn’t present during the test. Figures right?!

Thanks for sharing!