What is Red Ear Syndrome?

"Red Ear Syndrome" attacks are episodes of burning pain of one ear, often provoked by touch, neck movement or straining.

The condition has probably been around for centuries, but was only ever published in 1996 by the Australian Neurologist JW Lance.

This page is a summary of all 24 published reports on Red Ear Syndrome, and includes information based on all 60 cases described in the literature to date.

Who usually gets this?

Although the original reports describe women, it affects men and women equally, with people aged from childhood into their 90's reported.

Attacks of Red Ear can last anything from 15 minutes to a couple of days, although most seem to last no more than 2-3 hours.

Some people will have a few minutes of a red, hot ear, and the redness does not spread beyond the ear, but cases with redness of the cheek or neck are reported.

This is sometimes followed by pain on the same side of the head or face or ear.

Some people will only have reddening of the ear without much in the way of pain. The pain is often described as 'burning'.

Recorded triggers include:

  1. Neck rotation
  2. Touch e.g. lying down on the affected side
  3. Cough
  4. Sneezing
  5. Hot environment
  6. Washing or brushing hair
  7. Drinking or chewing

It is unlikely that there is a serious cause for these symptoms. 

There have been single cases of thse conditions happening before diagnosis of red ear syndrome:

  1. Chiari Malformation
  2. Osteoarthritic degeneration of C2/3/4 facet (zygoapophyseal) joints
  3. Thalamic Stroke (which causes a centrally generated pain syndrome)
  4. TMJ Dysfunction
  5. Carotid Artery Disease (occlusion or carotid body tumour - 1 case each)
  6. Herpes Zoster
  7. Migraine with aura - may occur at same time as red ear or independently of red ear

There are three cases of 'secondary' red ear syndrome due to a rare burning skin disease called erythromelalgia - these are listed in the case reports published in Google Drive (see link above or see References Section below).


What are the Treatments?

Red ears may be due to abnormal regulation of the blood flow to the ear due to sypmpathetic nerve dysfunction. This results in increased blood flow, which then causes the ear to turn red.

Treatment tried in individual cases include the following, but they are strictly on a trial and error basis.

None are proven in scientific studies, but are seen as a reasonable bet given that these treatments seem to work in other headache disorders:

  1. Nerve Block (local anaesthetic and steroid)
  2. Gabapentin
  3. Tricyclic anti-depressants (Amitryptilinr, Imipramine)
  4. Non-steroidal anti-inflammatory drugs (Ibuprofen, Meloxicam, Indomethacin)
  5. Calcium channel blocker drugs (Nimodipine, Verapamil)
  6. Combinations of the above.

In my limited experience - this can be difficult to treat. However, very disabling cases are not commonly reported, and there is at least a list of medications to try, even if on a speculative basis.

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References

If there are no references listed, please notify me, as this box should contain a list of information sources, or a link to a 'Systematic Review' of the topic discussed on this page.

Below is a link to an automatically updated Google Spreadsheet with a summary of all 24 references, 60 published cases and 2 case series on Red Ear Syndrome. 

It is the definitive summary on the internet.

You can scroll through the document, and are free to share the information.

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Links on this site

Go to Severe Headache Expert Home Page from Red Ear Syndrome