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What Causes Eye Pain, Pupil Dilation, Neck Pain And Lump Behind Ear?

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Posted on Thu, 20 Aug 2015
Question: My 17 year old daughter woke up with severe eye pain, pupil dilation, troubling speaking, neck pain and has a hard stable lump behind her ear.
doctor
Answered by Dr. Dr. Erion Spaho (15 minutes later)
Brief Answer:
Urgent medical evaluation needed.

Detailed Answer:
Hello and thanks for using HCM.

I have read your query and understand your concerns.

These new symptoms are serious ones and need urgent neurologic and imaging evaluation.

Probably there happened a spontaneous carotid-cavernous fistula.

Slurred speech and vision disturbances are symptoms of Shy-Drager as well, but onset is not abrupt.

In conclusion, these acute neurologic findings need a prompt medical and imaging evaluation.

Hope you found the answer helpful.

I remain at your disposal for further questions and clarifications.

Take care.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Dr. Erion Spaho (29 minutes later)
I research Shy-Drager syndrome and I do not see it occurring in a 17 year old female. The doctor is competent and my daughter is considered in the evaluation process, but he changed her diagnose recently to this syndrome since the original visit when we discussed Dysautonomia orthostatic hypotension syndrome
doctor
Answered by Dr. Dr. Erion Spaho (1 hour later)
Brief Answer:
Test results needed to be evaluated.

Detailed Answer:
Welcome back.

The way I see, there are two conditions to deal with:

- one condition with acute neurologic symptoms that needs prompt evaluation.

- one chronic condition in diagnostic process.

If you want to talk about Shy Drager (or multiple system atrophy) that's fine, but you should provide imaging and other test results done till now.

It is true that Shy Drager is a condition of the fifth and sixth decade, with rare cases diagnosed as young as 30 years old not younger (this regarding to literature as far as I know), so other conditions should be evaluated too.

Again, in my opinion, those abrupt symptoms need urgent evaluation.

Hope you found the answer helpful.

Take care.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dr. Erion Spaho (1 hour later)
I did make an appointment with PCP and she in turn is contacting my daughter's neurologist. Only concern for doctor was the slight drooping on the right side of her mouth. The lump believed to be swollen gland the eyes dually noted of no concern considering possibility of MRI in the next 24 hours
doctor
Answered by Dr. Dr. Erion Spaho (1 hour later)
Brief Answer:
MRI will give important information.

Detailed Answer:
Hi again.

You reported a dilated pupil and this is an alarming neurologic sign.

MRI will give a lot of information about the swollen gland behind the ear, and about those new neurologic symptoms.

Hope to hear good things soon about your doughter's condition.

Take care.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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What Causes Eye Pain, Pupil Dilation, Neck Pain And Lump Behind Ear?

Brief Answer: Urgent medical evaluation needed. Detailed Answer: Hello and thanks for using HCM. I have read your query and understand your concerns. These new symptoms are serious ones and need urgent neurologic and imaging evaluation. Probably there happened a spontaneous carotid-cavernous fistula. Slurred speech and vision disturbances are symptoms of Shy-Drager as well, but onset is not abrupt. In conclusion, these acute neurologic findings need a prompt medical and imaging evaluation. Hope you found the answer helpful. I remain at your disposal for further questions and clarifications. Take care.