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Suggest Treatment For Sharp Stabbing Pain Behind The Ear
Question: I have been getting an intense sharp stabbing pain behind my left ear near the base of my skull. It only lasts for a fews seconds each time. This has happened about twelve times today.
Brief Answer:
Occipital neuralgia possible.
Detailed Answer:
I read your question carefully and I understand your concern.
That description of stabbing short lasting pain is typical of a neuralgia, pain due to a damaged nerve. That damage may be due to a trauma, compression by nearby structures such as arthritic changes, viral infections etc, often the cause is difficult to identify.
Considering your pain location the nerve most probably involved is the minor occipital nerve, an occipital neuralgia. Most often related to arthritic changes in the neck. Is diagnosed by local exam, triggering of pain by palpation on nerve trajectory, if in doubt nerve blocks (injection of local anesthetic on the nerve root) can confirm the diagnosis. If persistent then medication like gabapentin or pregabalin are often used to prevent the pain.
A more rarely involved nerve can be the great auricular nerve, but very rare, similar considerations can be made on diagnosis and treatment.
Other possible causes could be an ear infection, the initial manifestation of facial nerve damage, temporomandibular joint dysfunction. In these conditions usually the pain is more persistent but it can have variations with paroxysmal stabbing exacerbations.
I remain at your disposal for other questions.
Occipital neuralgia possible.
Detailed Answer:
I read your question carefully and I understand your concern.
That description of stabbing short lasting pain is typical of a neuralgia, pain due to a damaged nerve. That damage may be due to a trauma, compression by nearby structures such as arthritic changes, viral infections etc, often the cause is difficult to identify.
Considering your pain location the nerve most probably involved is the minor occipital nerve, an occipital neuralgia. Most often related to arthritic changes in the neck. Is diagnosed by local exam, triggering of pain by palpation on nerve trajectory, if in doubt nerve blocks (injection of local anesthetic on the nerve root) can confirm the diagnosis. If persistent then medication like gabapentin or pregabalin are often used to prevent the pain.
A more rarely involved nerve can be the great auricular nerve, but very rare, similar considerations can be made on diagnosis and treatment.
Other possible causes could be an ear infection, the initial manifestation of facial nerve damage, temporomandibular joint dysfunction. In these conditions usually the pain is more persistent but it can have variations with paroxysmal stabbing exacerbations.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. Taka. I have had similer pain in other places on my head. The local neurologist that I had seen for the others had told me there was nothing to be done for the pain. He just told me that due to the fact that it occures at random times and only lasts for a few seconds that there was nothing to be done except to try a headache preventative medication. It was actually an anti-seizure medication but did not help.
Brief Answer:
Read below.
Detailed Answer:
Thank you for that additional information. From your initial query I had the impression that the pain was at the same constant location and only the last few days.
The fact that you get similar pain at other locations changes my opinion as it doesn't correspond now to a single nerve (or to those other conditions I mentioned). In that case it could be what is called primary stabbing headache, primary meaning no cause can be identified.
The neurologist is right is saying that since it lasts only a few seconds preventive medication is the only measure, recommended when the episodes are frequent. Apart from seizure medication which you mention, another option is an antidepressive like amitriptyline, which is also used for headache prevention. For primary stabbing headache also preventive use of Indomethacine can be effective.
I hope to have been of help.
Read below.
Detailed Answer:
Thank you for that additional information. From your initial query I had the impression that the pain was at the same constant location and only the last few days.
The fact that you get similar pain at other locations changes my opinion as it doesn't correspond now to a single nerve (or to those other conditions I mentioned). In that case it could be what is called primary stabbing headache, primary meaning no cause can be identified.
The neurologist is right is saying that since it lasts only a few seconds preventive medication is the only measure, recommended when the episodes are frequent. Apart from seizure medication which you mention, another option is an antidepressive like amitriptyline, which is also used for headache prevention. For primary stabbing headache also preventive use of Indomethacine can be effective.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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