1
|
Callan GM, Freitag F, Tolebeyan AS. Red ear syndrome: a case series and review of the literature. J Med Case Rep 2024; 18:327. [PMID: 38978093 PMCID: PMC11232128 DOI: 10.1186/s13256-024-04485-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/01/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Red Ear Syndrome is a burning sensation and erythema of the ear, associated with a various number of disorders including migraine, trigeminal neuralgia, autoimmune disorders etc. Theories for RES pathophysiology have developed from current understandings of comorbid conditions. Characterizing the underlying mechanism of RES is crucial for defining effective treatments. CASE PRESENTATION Three caucasian patients, ages 15, 47, and 67 years, with migraine, one with erythromelalgia are reported in this manuscript. RES pathophysiology is not fully understood due to its variable clinical presentation and numerous comorbid conditions, making it difficult to identify effective treatments. CONCLUSION RES seems to be largely treatment-resistant, and most options involve treating the associated disorders and minimizing pain. Further investigation of future cases should lead to a more comprehensive understanding of the fundamental cause of RES and, hopefully, successful treatments.
Collapse
|
2
|
Correnti E, Lo Cascio S, Cernigliaro F, Rossi R, D'Agnano D, Grasso G, Pellegrino A, Lauria B, Santangelo A, Santangelo G, Tripi G, Versace A, Sciruicchio V, Raieli V. Idiopathic Non-Dental Facial Pain Syndromes in Italian Children: A Clinical Case Series. Life (Basel) 2023; 13:life13040861. [PMID: 37109390 PMCID: PMC10144764 DOI: 10.3390/life13040861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/08/2023] [Accepted: 03/19/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The orofacial pain syndromes (OFPs) are a heterogeneous group of syndromes characterized by painful attacks involving the orofacial structures. They may be summarily subdivided into two great categories: (1) orofacial pain mainly attributed to dental disorders such as dentoalveolar and myofascial orofacial pain or temporomandibular joint (TM) pain; (2) orofacial pain mainly attributed to non-dental pain as neuralgias, facial localization of primary headaches or idiopathic orofacial pain. The second group is uncommon, often described by single case reports, can often show overlapping symptoms with the first group, and represents a clinical challenge, carrying the risk of undervaluation and possibly invasive odontoiatric treatment. We aimed to describe a clinical pediatric series of non-dental orofacial pain and better to underline some topographic and clinical features associated with them. We retrospectively collected the data of children admitted to our headache centers (Bari, Palermo, Torino) from 2017 to 2021. Our inclusion criterion was the presence of non-dental orofacial pain following the topographic criteria of 3° International Classification of Headache Disorders (ICHD-3), and exclusion criteria included the pain syndromes attributed to the dental disorders and pain syndromes due to the secondary etiologies Results. Our sample comprised 43 subjects (23/20 M/F, in the range of ages 5-17). We classified them int: 23 primary headaches involving the facial territory during attacks, 2 facial trigeminal autonomic cephalalgias, 1 facial primary stabbing headache, 1 facial linear headache, 6 trochlear migraines, 1 orbital migraine 3 red ear syndrome and 6 atypical facial pain. All patients described debilitating pain for intensity (moderate/severe), 31 children had episodic attacks, and 12 had continuous pain. Almost all received drugs for acute treatment (less than 50% were satisfied), and some received non-pharmacological treatment associated with drug therapy Conclusion. Although rare OFP can occur in pediatric age, it can be debilitating if unrecognized and untreated, affecting the psychophysical well-being of young patients. We highlight the specific characteristics of the disorder for a more correct and earlier identification during the diagnostic process, already difficult in pediatric age, and to define the approach and possible treatment to prevent negative outcomes in adulthood.
Collapse
Affiliation(s)
- Edvige Correnti
- Child Neuropsychiatry Department, ISMEP, ARNAS Civico, 90100 Palermo, Italy
| | - Salvatore Lo Cascio
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G. D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Federica Cernigliaro
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G. D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Roberta Rossi
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Daniela D'Agnano
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
| | - Giulia Grasso
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Annamaria Pellegrino
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
| | - Barbara Lauria
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Andrea Santangelo
- Pediatrics Department, AOUP Santa Chiara Hospital, 56126 Pisa, Italy
| | | | - Gabriele Tripi
- Child Neuropsychiatry Unit Department, Pro.M.I.S.E. "G. D'Alessandro", University of Palermo, 90100 Palermo, Italy
| | - Antonella Versace
- Pediatric Headache Center, Pediatric Emergency Department, Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Vittorio Sciruicchio
- Children Epilepsy and EEG Center, San Paolo Hospital, ASL Bari, 70132 Bari, Italy
| | - Vincenzo Raieli
- Child Neuropsychiatry Department, ISMEP, ARNAS Civico, 90100 Palermo, Italy
| |
Collapse
|
3
|
Lax DN, Sitterle K, Kacperski J, Hershey AD, Kabbouche M. Indomethacin-responsive idiopathic red ear syndrome: A pediatric case. Headache 2022; 62:1432-1433. [PMID: 36373805 DOI: 10.1111/head.14416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Daniel N Lax
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Division of Child Neurology, Montefiore Medical Center, Bronx, New York, USA
| | - Kelly Sitterle
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Joanne Kacperski
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Andrew D Hershey
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Marielle Kabbouche
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| |
Collapse
|
4
|
Fernandez-Vial D, Sangalli L, Perez C. A Rare Case of Idiopathic Painful Nervus Intermedius Neuropathy in a 13-Year-Old Female: A Case Report and Discussion in the Context of the Literature. CHILDREN 2022; 9:children9081234. [PMID: 36010124 PMCID: PMC9406721 DOI: 10.3390/children9081234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022]
Abstract
(1) Background: Painful nervus intermedius neuropathy involves continuous or near-continuous pain affecting the distribution of the intermedius nerve(s). The diagnosis of this entity is challenging, particularly when the clinical and demographic features do not resemble the typical presentation of this condition. To the best of our knowledge, only three case reports have described the occurrence of nervus intermedius neuropathy in young patients. (2) Case Description: A 13-year-old female referred to the orofacial pain clinic with a complaint of pain located deep in the right ear and mastoid area. The pain was described as constant, throbbing and dull, with an intensity of 7/10 on numerical rating scale, characterized by superimposed brief paroxysms of severe sharp pain. The past treatments included ineffective pharmacological and irreversible surgical approaches. After a comprehensive evaluation, a diagnosis of idiopathic painful nervus intermedius neuropathy was given, which was successfully managed with the use of gabapentin. (3) Conclusions and Practical Implications: The diagnosis and treatment of neuropathic pain affecting the nervus intermedius can be challenging due to the complex nature of the sensory innervation of the ear. The diagnosis can be even more challenging in cases of atypical clinical and demographic presentations, which in turn may result in unsuccessful, unnecessary, and irreversible treatments. Multidisciplinary teams and constant knowledge update are fundamental to provide good quality of care to our patients and not to overlook any relevant signs or symptoms.
Collapse
|
5
|
Raieli V, Reina F, D’Agnano D, Nocera GM, Capizzi M, Marchese F, Sciruicchio V. The Pediatric Trochlear Migraine: Diagnostic and Therapeutic Implications. J Clin Med 2022; 11:2826. [PMID: 35628950 PMCID: PMC9142906 DOI: 10.3390/jcm11102826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022] Open
Abstract
Trochlear Migraine has been recently described as the concurrence of strictly unilateral migraine and ipsilateral trochleodynia with relief of migraine after successful treatment of trochleodynia. This disorder has been interpreted as "cluster-tic syndrome" or "seizure-triggered migraine". Trochlear Migraine is unrecognized and rarely described in childhood. The aim of this study is to review the few cases of Trochlear Migraine reported in the literature in addition to the cases observed in our clinical experience. In particular, our cases showed recurrent attacks of severe and pulsating headache associated with nausea, vomiting, phonophobia, photophobia, and strict trochlear localization of pain. They often presented with alternating side attacks. Therefore, we suggest that the term "Trochlear Migraine" should be reserved for clinical migraine attacks strictly localized in the trochlear region, and we assume that the excessive increase in descriptions of new primary headache syndromes, according to the International Classification of Headache Disorders, can be probably be ascribed to the common physiopathological mechanisms characterizing these forms of migraine.
Collapse
Affiliation(s)
- Vincenzo Raieli
- Child Neuropsychiatry Unit ISMEP, ARNAS Civico, 90134 Palermo, Italy;
| | - Federica Reina
- Child Neuropsychiatry School, University of Palermo, 90128 Palermo, Italy; (F.R.); (G.M.N.); (M.C.)
| | - Daniela D’Agnano
- Children Epilepsy and EEG Center, PO, San Paolo ASL, 70132 Bari, Italy; (D.D.); (V.S.)
| | - Giovanna Martina Nocera
- Child Neuropsychiatry School, University of Palermo, 90128 Palermo, Italy; (F.R.); (G.M.N.); (M.C.)
| | - Mariarita Capizzi
- Child Neuropsychiatry School, University of Palermo, 90128 Palermo, Italy; (F.R.); (G.M.N.); (M.C.)
| | | | - Vittorio Sciruicchio
- Children Epilepsy and EEG Center, PO, San Paolo ASL, 70132 Bari, Italy; (D.D.); (V.S.)
| |
Collapse
|
6
|
Courtney A, Holmes Z, Weston S. If your ears are burning we must be talking about red ear syndrome: A brief report. Australas J Dermatol 2022; 63:e244-e246. [PMID: 35510338 DOI: 10.1111/ajd.13862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/13/2022] [Accepted: 04/17/2022] [Indexed: 11/28/2022]
Abstract
Red Ear Syndrome is an uncommon disorder that can affect all age groups. It is frequently referred to Dermatology as it can present similarly to erythromelalgia. Although the exact pathophysiology is unknown, a common hypothesis suggests a shared pathophysiological background with migraine due to their well-known association. Currently, there are no established treatment guidelines. Delays in accurate diagnosis and commencing optimal treatment can significantly negatively impact on a patients quality of life. We discuss the clinical presentation and response to treatment of a case of Red Ear Syndrome in an 8-year-old boy.
Collapse
Affiliation(s)
- Ashling Courtney
- Dermatology Department, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Zack Holmes
- Dermatology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Stephanie Weston
- Dermatology Department, Perth Children's Hospital, Nedlands, Western Australia, Australia
| |
Collapse
|
7
|
Borri J, Silva Junior HMD. Red Ear Syndrome and migraine: case report and review of this peculiar association. HEADACHE MEDICINE 2022. [DOI: 10.48208/headachemed.2021.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Introduction: The "Red Ear Syndrome" (RES) is a rare condition (about 100 cases were published in 25 years). It is characterized by episodes of hyperemia of the ear associated with burning pain. Although the association of this syndrome and primary headaches is contemplated in literature, its etiology and treatments are still poorly defined.
The aim of this paper is to report a case of RES related to migraine and possible pathophysiologic mechanisms.
Case Report: A 31-year-old woman presented with stabbing pain and marked erythema and edema of the right ear accompanied by burning and local hyperhidrosis. These attacks lasted 2 hours on average, and either occurred spontaneously or were associated with migraine without aura. The only means of relief during the attacks was cooling the local with ice.
Extensive laboratory-chemical, microbiological, ear-nose-throat, clinical and neurological examinations, magnetic resonance of the brain and cervical spine were unremarkable.
Conclusion: Uncertainty about the etiology of this syndrome is an obstacle to treatment. The frequent relationship between RES and migraine suggests that is necessary to investigate the syndrome in migraineurs. Furthermore, new reports about this disorder are important to increase the knowledge of physicians, to reduce the delay in diagnosis and suffering of patients.
Collapse
|
8
|
Oliveira ADP, Silva-Néto RP. Circadian rhythmicity on red ear syndrome in a patient with migraine: A case report. Headache 2021; 61:1581-1583. [PMID: 34873689 DOI: 10.1111/head.14242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Red ear syndrome (RES) was first described by Lance in 1994. It is characterized by recurrent attacks of redness of the ear, accompanied by burning pain, increased temperature, dysesthesia, and nosological relationship with headache. CASE We report the case of a 43-year-old woman with migraine who developed RES. Redness episodes occurred at the same time of the day. She had a good therapeutic response to gabapentin. CONCLUSIONS To the best of our knowledge, this is the first case of RES in which redness episodes occurred at the same time of the day.
Collapse
|
9
|
Starling CT, Nguyen QBD, Butler IJ, Numan MT, Hebert AA. Cutaneous manifestations of orthostatic intolerance syndromes. Int J Womens Dermatol 2021; 7:471-477. [PMID: 34621961 PMCID: PMC8484984 DOI: 10.1016/j.ijwd.2021.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/05/2021] [Accepted: 03/05/2021] [Indexed: 11/27/2022] Open
Abstract
Dysautonomia refers to a group of autonomic nervous system disorders that affect nearly 70 million people worldwide. One subset of dysautonomia includes syndromes of orthostatic intolerance (OI), which primarily affect adolescents and women of childbearing age. Due to the variability in disease presentation, the average time from symptom onset to diagnosis of dysautonomia is 6 years. In general, there is a paucity of dermatological research articles describing patients with dysautonomia. The objective of this review is to summarize the existing literature on cutaneous manifestations in dysautonomia, with an emphasis on syndromes of OI. A PubMed database of the English-language literature (1970–2020) was searched using the terms “dysautonomia”, “orthostatic intolerance”, “cutaneous”, “skin”, “hyperhidrosis”, “hypohidrosis”, “sweat”, and other synonyms. Results showed that cutaneous manifestations of orthostatic intolerance are common and varied, with one paper citing up to 85% of patients with OI having at least one cutaneous symptom. Recognition of dermatological complaints may lead to an earlier diagnosis of orthostatic intolerance, as well as other comorbid conditions.
Collapse
Affiliation(s)
| | - Quoc-Bao D Nguyen
- Department of Dermatology, UTHealth McGovern Medical School at Houston, Houston, Texas
| | - Ian J Butler
- Department of Pediatrics, UTHealth McGovern Medical School at Houston, Houston, Texas
| | - Mohammed T Numan
- Department of Pediatrics, UTHealth McGovern Medical School at Houston, Houston, Texas
| | - Adelaide A Hebert
- Department of Dermatology, UTHealth McGovern Medical School at Houston, Houston, Texas.,Department of Pediatrics, UTHealth McGovern Medical School at Houston, Houston, Texas
| |
Collapse
|
10
|
D'Amico A, Galati C, Manzo ML, Reina F, Nocera GM, Raieli V. Red ear syndrome in children: Review of literature and report of three cases. Int J Pediatr Otorhinolaryngol 2021; 142:110615. [PMID: 33440309 DOI: 10.1016/j.ijporl.2021.110615] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/31/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Red ear syndrome (RES) is a neurological syndrome that is characterized by attacks of redness and pain that is localized in the earlobe, accompanied by a burning sensation, swelling or otalgia. The exact pathophysiology of RES is not known. Several pediatric cases have been described. They show an extreme variability in clinical presentation and therapeutic response, and therefore there are numerous difficulties in the diagnostic-therapeutic approach and in the comprehension of the physiopathology. The goal of this report is to present three clinical cases of red ear syndrome in children. These cases show various characteristics that can give useful indications regarding the differential diagnosis and the pathogenetic mechanisms that are involved, particularly when they are compared with cases published in the literature. CASE-REPORTS We report three pediatric RES cases: 1) a boy whose condition offered a typical example of the association that occurs between migraine and RES. 2) a girl with idiopathic RES. 3) a child who suffered RES attacks that showed many similarities with trigeminal autonomic cephalalgias. CONCLUSION Our clinical series shows the different ways in which RES can be expressed and they support the reported scientific literature. We suggest that the different forms of RES have a common final autonomic pathogenetic mechanism that is activated by parasympathetic hyperactivity and sympathetic inhibition. The different temporal characteristics, frequency, etc. may depend on the activation of distinct physiopathological modules that are related to the pain circuits, as suggested by the modular theory which describes that groups of neurons are defined as a module, where each module is responsible for a symptom and the individual's headache is defined by the activated modules.
Collapse
Affiliation(s)
- Antonina D'Amico
- Child Neuropsychiatry School - University of Palermo, Piazzale Delle Cliniche Palermo, 90100, Italy
| | - Cristina Galati
- Child Neuropsychiatry School - University of Palermo, Piazzale Delle Cliniche Palermo, 90100, Italy
| | - Maria Laura Manzo
- Child Neuropsychiatry School - University of Palermo, Piazzale Delle Cliniche Palermo, 90100, Italy
| | - Federica Reina
- Child Neuropsychiatry School - University of Palermo, Piazzale Delle Cliniche Palermo, 90100, Italy
| | - Giovanna Martina Nocera
- Child Neuropsychiatry School - University of Palermo, Piazzale Delle Cliniche Palermo, 90100, Italy
| | - Vincenzo Raieli
- Child Neuropsychiatry Unit- ISMEP -P.O. Cristina - ARNAS Civico, Via Dei Benedettini 1Palermo, 90100, Italy.
| |
Collapse
|
11
|
Soares C, Alves F, Pinto M, Abreu P, Costa A. Red Ear Syndrome After Tympanoplasty: A New Association to Add to the List! Headache 2020; 60:2081-2082. [PMID: 32853394 DOI: 10.1111/head.13944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Carolina Soares
- Department of Neurology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Filipe Alves
- Family Health Unit Infesta, ULS de Matosinhos, Matosinhos, Portugal
| | - Madalena Pinto
- Department of Neurology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - Pedro Abreu
- Department of Neurology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andreia Costa
- Department of Neurology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
12
|
Khalil S, Kurban M, Abbas O. Red scrotum syndrome: An update on clinicopathologic features, pathogenesis, diagnosis, and management. J Am Acad Dermatol 2020; 87:614-622. [DOI: 10.1016/j.jaad.2020.05.113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 11/30/2022]
|
13
|
Duvall JR, Garza I, Kissoon NR, Robertson CE. Great Auricular Neuralgia: Case Series. Headache 2019; 60:247-258. [DOI: 10.1111/head.13690] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Jaclyn R. Duvall
- Headache Division Department of Neurology Mayo Clinic Rochester MN USA
| | - Ivan Garza
- Headache Division Department of Neurology Mayo Clinic Rochester MN USA
| | | | | |
Collapse
|
14
|
Cinats AK, Haber RM. Pediatric red ear syndrome: A case report of an erythromelalgia type and review of the literature. Pediatr Dermatol 2019; 36:686-689. [PMID: 31259429 DOI: 10.1111/pde.13911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Red ear syndrome has been reported in the literature to have similarities to erythromelalgia with auricular involvement; however, the distinction between the two is controversial. Red ear syndrome has previously been classified as idiopathic (primary) or secondary, with headaches being the most common association in the idiopathic or primary form. We present a case of pediatric red ear syndrome with hand and foot involvement that we believe represents auricular erythromelalgia. In this report, we propose a classification system to unify the diagnoses of red ear syndrome and erythromelalgia and review the literature on pediatric cases of red ear syndrome.
Collapse
Affiliation(s)
- Allison K Cinats
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Richard M Haber
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
15
|
Raieli V, D'Amelio M, Brighina F. The Mystery of “Red Ear Syndrome”: Sign or Syndrome. Headache 2019; 59:624-625. [DOI: 10.1111/head.13524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Vincenzo Raieli
- Child Neuropsychiatry Department UO NPI, ISMEP ‐ ARNAS Civico Palermo Palermo Italy
| | - Marco D'Amelio
- Department of Experimental Biomedicine and Clinical Neurosciences University of Palermo Palermo Italy
| | - Filippo Brighina
- Department of Experimental Biomedicine and Clinical Neurosciences University of Palermo Palermo Italy
| |
Collapse
|
16
|
|
17
|
Abstract
Vague complaints of ear pain can bring frustration in the neurology office as the differential is broad and often nonneurologic. Herein, we present a case of red ear syndrome, a treatable migraine variant that can cause significant distress and lead to delayed treatment if not considered as a diagnostic possibility.
Collapse
Affiliation(s)
- Juliana Coleman
- Department of Neurology, The Ohio State School of Medicine, Columbus, OH
| | - Margie A Ream
- Division of Pediatric Neurology, Nationwide Children's Hospital, Columbus, OH.
| |
Collapse
|
18
|
Abstract
Erythromelalgia is a rare syndrome characterized by the intermittent or, less commonly, by the permanent occurrence of extremely painful hyperperfused skin areas mainly located in the distal extremities. Primary erythromelalgia is nowadays considered to be a genetically determined neuropathic disorder affecting SCN9A, SCN10A, and SCN11A coding for NaV1.7, NaV1.8, and NaV1.9 neuronal sodium channels. Secondary forms might be associated with myeloproliferative disorders, connective tissue disease, cancer, infections, and poisoning. Between the pain episodes, the affected skin areas are usually asymptomatic, but there are patients with typical features of acrocyanosis and/or Raynaud's phenomenon preceding or occurring in between the episodes of erythromelalgia. Diagnosis is made by ascertaining the typical clinical features. Thereafter, the differentiation between primary and secondary forms should be made. Genetic testing is recommended, especially in premature cases and in cases of family clustering in specialized genetic institutions after genetic counselling. Multimodal therapeutic intervention aims toward attenuation of pain and improvement of the patient's quality of life. For this purpose, a wide variety of nonpharmacological approaches and pharmacological substances for topical and systemic use have been proposed, which are usually applied individually in a step-by-step approach. Prognosis mainly depends on the underlying condition and the ability of the patients and their relatives to cope with the disease.
Collapse
Affiliation(s)
| | | | - Jutta Gisela Richter
- 2 Poliklinik, Funktionsbereich und Hiller Forschungszentrum für Rheumatologie, Medizinische Fakultät, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| |
Collapse
|
19
|
Chan TLH, Becker WJ, Jog M. Indomethacin-Responsive Idiopathic Red Ear Syndrome: Case Report and Pathophysiology. Headache 2017; 58:306-308. [PMID: 29193054 DOI: 10.1111/head.13237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 10/20/2017] [Accepted: 11/01/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Tommy L H Chan
- Department of Clinical Neurological Sciences, London Health Sciences Centre (LHSC), University of Western Ontario, London, Ontario, Canada
| | - Werner J Becker
- Department of Clinical Neurosciences & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, London Health Sciences Centre (LHSC), University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
20
|
Food-Induced Red Eye. Optom Vis Sci 2017; 94:775-780. [DOI: 10.1097/opx.0000000000001088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
21
|
Eghtesadi M, Leroux E, Vargas-Schaffer G. A case report of complex auricular neuralgia treated with the great auricular nerve and facet blocks. J Pain Res 2017; 10:435-438. [PMID: 28255253 PMCID: PMC5322840 DOI: 10.2147/jpr.s126923] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The great auricular nerve is a cutaneous branch of the cervical plexus originating from the C2 and C3 spinal nerves. It innervates the skin over the external ear, the angle of the mandible and the parotid gland. It communicates with the ansa cervicalis. Great auricular neuralgia is rarely diagnosed in clinical practice and can be refractory. We present a new approach using ultrasound-guided nerve blocks. CASE We present a case of a 41-year-old female with paroxysmal ear pain accompanied by dysautonomia, tingling in the tongue, dysphagia, dysarthria and abdominal symptoms. No significant findings were found on cervical and brain imaging. The patient responded partially to a great auricular nerve block. A combined approach using this block with facet block of C2 and C3 induced a more pronounced and prolonged benefit. CONCLUSION Great auricular neuralgia is not often encountered in practice and can be accompanied by symptoms originating from the ansa cervicalis network. A combined approach of nerve blocks can be considered in refractory cases.
Collapse
Affiliation(s)
- Marzieh Eghtesadi
- Department of Pain Clinic, Headache Management, Centre Hospitalier de l'Université de Montréal (CHUM), Centre de Recherche de l'Université de Montréal (CRCHUM)
| | - Elizabeth Leroux
- Department of General Neurology, Headache Management, Centre Hospitalier de l'Université de Montréal (CHUM), Centre de Recherche de l'Université de Montréal (CRCHUM)
| | - Grisell Vargas-Schaffer
- Department of Anesthesiology, Pain Clinic, Centre Hospitalier de l'Université de Montréal (CHUM), Centre de Recherche de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| |
Collapse
|