Hi, thanks for asking from HCM. I can understand your concern. You are having right sided headache, mainly behind ear along with nausea, dizziness, blurred vision. Such kind of focal headache along with generalised symptoms could be due to - Migraine - Migraine is usually one sided headache, along with vomiting, photophobia, blurred vision. This headache is mostly preceded by aura symptoms such as bad smell/bad taste/uneasiness. It occurs in season. There are few precipitating factors like stress, light, insomnia, eating cheese, change in season. - Right side mastoiditis - It can cause pin behind ear, fever, generalised symptoms as you mentioned. It usually occurs after ear infection so ear discharge, hearing loss are also other usual features. - Right side brain mass lesion - If there is focal headache, there is possibility of brain mass like tumor, vascular malformation, abscess. Mass lesion in right temporal region can present with above mentioned features. - Right sternocleidomastoid muscle spasm - Severe spasm of this muscle can cause pain behind ear, burning, nausea, pain increases on movement of neck. There will be local tenderness over the muscle. These are the most common possibilities. Now to reach at some conclusion, you should get yourself examined. After examination, few investigations will be needed to confirm the diagnosis. These investigations are - MRI brain to rule out mass lesion in brain - HRCT temporal lobe to find mastoiditis - Ear examination and audiometery to rule out ear pathology After excluding other causes, we can suspect Migraine. Usual approach to each condition is different. I am briefly describing each - Migraine is treated by abortive therapy (Naproxen/Diclofenac/Sumatriptan after prescription) and preventive therapy (Propranolol/Amitriptyline/Gabapnetine). - Mastoiditis is treated by intravenous antibiotics like co-amoxyclav, metronidazole and amikacin therapy, maintaining hygiene in ear. - Brain mass lesion are mostly managed by surgical excision. - Sternocleidomastoid spasm is managed by rest, painkillers like Diclofenac, neck massage, physiotherapy and hot fomentation. After confirming diagnosis, you can send me the reports, I will guide you. Hope it will help you. Thanks. Take care.