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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Exp 50 years

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What causes pain in ear radiating to nose?

Answered by
Dr.
Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2589 Questions

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Posted on Wed, 25 Feb 2015 in Ear, Nose and Throat Problems
Question: I had a stroke in April 2014. Since then I have experienced what feels like ear aches...but painful and tender to touch my outer left ear and .....it hurts where my ear is connected to my face...the pain also radiates down into my face, and sometimes towards my nose and sinus. My dentist says it is not to do with my teeth, or jaw. The pain starts seemingly with no warning, carries on, gets worse, and then awhile later quits. Could this have something to do with heart or stroke?
doctor
Answered by Dr. Sumit Bhatti 1 hour later
Brief Answer:
Trigeminal Neuralgia.

Detailed Answer:
Hi,

Thank you for your query.

1. This seems to be a Trigeminal Neuralgia.

2. The possible causes are:
a. Post Stroke Trigeminal Neuralgia or lower brainstem stroke.
b. The initial cause for the stroke involving the Trigeminal Nerve, such as hypertension, atherosclerosis or a neurological disorder.
c. Muscle spasms and contractures after a stroke leading to this pain.
d. A distinct entity.

3. Neuralgia usually do not respond to muskuloskeletal (routine) painkillers. There are separate classes of painkillers for neuralgias. A Neurologist will be able to prescribe these for you.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti 19 days later
Hi Doctor... I had a CT scan and they said it was osteo- arthritis of the joint in my jaw. Is that the same as TMJ? What would you suggest I do for pain relief?
doctor
Answered by Dr. Sumit Bhatti 13 hours later
Brief Answer:
TMJ OA is a type of TMJD.

Detailed Answer:
Hi,

Thank you for writing back.

1. Osteoarthritis (OA) of the jaw is one type of the many types of TMJ Disorders.

2. the pain sensations are still supplied by the Trigeminal Nerve.

3. The severity of the TMJ OA will decide the treatment. Mild OA can be manged by painkillers (for neuralgia), anti-inflammatory medication (including steroids) and fomentation.

4. Dental splints can ease the spasm. Moderate to severe OA can be traeted in addition with intralesional steroids, hyaluronidase and surgery of the TMJ.

5. For pain relief get a prescription for either amitriptyline, carbamazepine, gabapentin or pregabalin in addition to anti-inflammatory medication. These medications will have side effects in the long term.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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