Red Ear Syndrome and Migraine: Report of Eight Cases

Abstract

We describe eight idiopathic cases of red ear syndrome in seven children and one adult. All were migraineurs with a history of paroxysmally painful and red ear, unilateral or alternating, in isolation or associated with migraine attacks. The reported duration of these episodes varied from 30 minutes to 1 hour. Neurologic examination, brain MRI and CT scans, and x-rays of the cervical spine were normal. The close temporal relationship between the "red ear episodes" and migraine attacks suggests an association between the two conditions.

Red ear syndrome – Case report and review of literature

“…The prevalence of RES is also unknown, although it is thought that idiopathic RES is more common in children, while the secondary RES is probably more frequent in adults [6]. There are some articles that draw attention toward RES being associated with primary headache disorders, including migraine, chronic paroxysmal hemicranias (CPH), hemicrania continua (HC) and shortlasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) [7,8]. It is interesting that in our patient's case, the migraine without aura occurred about one year later after RES and usually migraine and RES appeared simultaneously on the same side of head.…”

“…The occurrence of symptoms of RES in clusters and coexistence of migraine with RES may support the association of RES with primary headache disorders, particularly with migraine and cluster headaches. On the basis of the available literature on RES, the differential diagnosis should be taken into account: upper cervical spine, trigeminal neuralgia, glossopharyngeal neuralgia, CPH, temporomandibular joint dysfunction, thalamic syndrome, migraine, otic zoster, herpes zoster virus infection of the C3-C6 dermatomes, Chiari type 1 malformation, SUNCT, erysipelas and exercise-induced compression of the cerebellar tonsils [1, 7,8]. In our patient's case the differential diagnosis were excluded.…”

Red Ear Syndrome: Case Report and Review of the Literature

“…These attacks occurred spontaneously or were induced by trigger factors such as mechanical trauma, heat or cold stimuli. In some patients, erythema was reported not only of the ear, but also affecting adjacent areas and individual parts of the face [2,3,4]. There were 25 (39.7%) men and 38 (60.3%) women.…”

The prevalence of allodynia, osmophobia and red ear syndrome in the juvenile headache: preliminary data

“…Lance [7] suggested a sympathetic hypofunction in the secondary red ear and an antidromic axonal reflex with the release of vasodilator peptide syndrome in idiopathic cases. Trigemino-vascular activation has been called to explain red ear syndrome associated to migraine [6,8]. The innervation of facial skin includes vasoconstrictor (under prevalent control of the sympathetic system) and vasodilator fibres (under control of the parasympathetic system) [7,13,14].…”