Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Severe Ear Pain, Dizziness And Headache With History Of Visual Aura?
Question: I have in the last eight months started experiencing what has been diagnosed as migraines with aura. At 43 years I have had not history of migraine and rarely get headache, and we have no family history of migraine. The thing is these have been preceded with sharp pains in my left ear, then an aura in my left eye. I have taken antibiotics for a possible inner ear infection, but it hasn't fixed it. And now I am suffering from almost constant ear pain (sometimes sharp stabbing, other times full pressure feeling, and sometimes hot burning feeling) as well as moments of blocked hearing, ringing in my ears and bad dizziness. I have been to a number of GPs and specialists but no one seems to know what it is. The common response is that it is just a migraine and I have to live with it but II don't agree. Plus it is becoming increasingly difficult to live with.
Brief Answer:
Need more description of the aura please
Detailed Answer:
Good evening and I'm very sorry to hear you've developed these unexpected problems at such an unexpected age. As an Adult Neurologist and Headache Specialist I agree that age 43 is an unusual age to develop migraine attacks in the face of no family history, no personal prior history, and no neurological symptoms either except for pain in the left ear. My patients all keep detailed headache DIARIES which contain a number of different parameters we track and target for treatment. Therefore, may I suggest you begin doing the same. There are a number of diaries for headaches you could download from the internet. There are also apps for smart phones. One of my favorites (though it's still not as complete as the one I give my patients) is called MIGRAINE BUDDY. It's a free app and you may check into it as a possibility. Then, you and your neurologist can review the data in your app to either discover a trigger(s) or determine exactly the right type of treatment you should be receiving for these headaches.
The stabbing pain in the ear reminds me of a possible acoustic, trigeminal, or glossopharyngeal NEURITIS in which case I may choose something on the order of Indomethacin or similar to see if some dose of this medication can quell the pains and thence the headaches. The only bad thing about Indomethacin is that in many individuals rather profound GI side effects begin to occur including darkening of the stool which indicates loss of blood from the gut. At any rate, I don't think that these ear pains represent infectious agents and this is supported by the fact that multiple regimens of antibiotics have failed to provide any relief.
Another rather common yet UNCOMMON because people (doctors) sometimes fail to remember it in the differential is that pain either in the ear or behind the ear of a sharp and sudden nature can be a sign of gastroesophageal reflux disease (GERD). Has this been considered and/or investigated? And if that's a possibility have you been checked for the Helicobacter Pylori organism that is generally found in the stomach causing this havoc? This is an easily detectable infection and just as easily treatable.
As far as "living" with the headache and its constellation of symptoms...again, I agree with your point of view and respectfully disagree with anyone who says that you simply should "live with it." I think that at the very least and if you are suffering from migraine headaches without causative factors or triggers that at least you can be offered proper medication for them. I hope the doctors looking at you have at least thought about the migraine specific medications which are now commonplace worldwide for these awful headaches.
Get a good diary and start tracking your headaches. Get a good neurologist who appreciates your keeping track of your events. Or come and visit me here in the United States as soon you will be passing your summer weather to our part of the globe! YEA! DO NOT OVERUSE MEDICATIONS SUCH AS TYLENOL, ADVIL, TYLENOL, PARACETAMOL, NAPROXEN, VOLTAREN, etc. etc.
I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload images if you'd like.
Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.
Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.
Many thanks for using this service to ask your questions. Be well.
This consult request has taken a total of 19 minutes of time to read, research, and respond.
Need more description of the aura please
Detailed Answer:
Good evening and I'm very sorry to hear you've developed these unexpected problems at such an unexpected age. As an Adult Neurologist and Headache Specialist I agree that age 43 is an unusual age to develop migraine attacks in the face of no family history, no personal prior history, and no neurological symptoms either except for pain in the left ear. My patients all keep detailed headache DIARIES which contain a number of different parameters we track and target for treatment. Therefore, may I suggest you begin doing the same. There are a number of diaries for headaches you could download from the internet. There are also apps for smart phones. One of my favorites (though it's still not as complete as the one I give my patients) is called MIGRAINE BUDDY. It's a free app and you may check into it as a possibility. Then, you and your neurologist can review the data in your app to either discover a trigger(s) or determine exactly the right type of treatment you should be receiving for these headaches.
The stabbing pain in the ear reminds me of a possible acoustic, trigeminal, or glossopharyngeal NEURITIS in which case I may choose something on the order of Indomethacin or similar to see if some dose of this medication can quell the pains and thence the headaches. The only bad thing about Indomethacin is that in many individuals rather profound GI side effects begin to occur including darkening of the stool which indicates loss of blood from the gut. At any rate, I don't think that these ear pains represent infectious agents and this is supported by the fact that multiple regimens of antibiotics have failed to provide any relief.
Another rather common yet UNCOMMON because people (doctors) sometimes fail to remember it in the differential is that pain either in the ear or behind the ear of a sharp and sudden nature can be a sign of gastroesophageal reflux disease (GERD). Has this been considered and/or investigated? And if that's a possibility have you been checked for the Helicobacter Pylori organism that is generally found in the stomach causing this havoc? This is an easily detectable infection and just as easily treatable.
As far as "living" with the headache and its constellation of symptoms...again, I agree with your point of view and respectfully disagree with anyone who says that you simply should "live with it." I think that at the very least and if you are suffering from migraine headaches without causative factors or triggers that at least you can be offered proper medication for them. I hope the doctors looking at you have at least thought about the migraine specific medications which are now commonplace worldwide for these awful headaches.
Get a good diary and start tracking your headaches. Get a good neurologist who appreciates your keeping track of your events. Or come and visit me here in the United States as soon you will be passing your summer weather to our part of the globe! YEA! DO NOT OVERUSE MEDICATIONS SUCH AS TYLENOL, ADVIL, TYLENOL, PARACETAMOL, NAPROXEN, VOLTAREN, etc. etc.
I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload images if you'd like.
Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.
Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.
Many thanks for using this service to ask your questions. Be well.
This consult request has taken a total of 19 minutes of time to read, research, and respond.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for the response. I have not heard of GERD so I will chat to my GP about getting a test done for it. Could this also cause the aura?
Regarding details of the aura, it is only in the left eye, and tends to be a vertical or slightly diagonal line of a rainbow of colours that wiggles / trembles. It is not exactly straight but a bit zig zaggy and it generally moves from the bottom to the top of the vision over a period of 20-30 minutes.
I have tracked these incidences and the common factors seem to be that they only happen when I am at work (I work in a office which is something I have done for about 15 years so no changes here) and they are generally preceded with ear pain.
Even though I am experiencing an aura, I am not convinced it is migraines, and I was thinking it was something else perhaps causing it (like your GERD suggestion). It is really just knowing in which direction I should look, or who I should speak to next.
Regarding details of the aura, it is only in the left eye, and tends to be a vertical or slightly diagonal line of a rainbow of colours that wiggles / trembles. It is not exactly straight but a bit zig zaggy and it generally moves from the bottom to the top of the vision over a period of 20-30 minutes.
I have tracked these incidences and the common factors seem to be that they only happen when I am at work (I work in a office which is something I have done for about 15 years so no changes here) and they are generally preceded with ear pain.
Even though I am experiencing an aura, I am not convinced it is migraines, and I was thinking it was something else perhaps causing it (like your GERD suggestion). It is really just knowing in which direction I should look, or who I should speak to next.
Brief Answer:
You are most welcome for the response
Detailed Answer:
I have not heard of GERD so I will chat to my GP about getting a test done for it. Could this also cause the aura?
>>>>>>>>>>> No, GERD is not related to the type of aura you are experiencing...that is seen most typically for migraine headache presentations.
Regarding details of the aura, it is only in the left eye, and tends to be a vertical or slightly diagonal line of a rainbow of colours that wiggles / trembles. It is not exactly straight but a bit zig zaggy and it generally moves from the bottom to the top of the vision over a period of 20-30 minutes.
>>>>>>>>>>>>>>>>>>>>> About visual aura. The aura itself is NOT CONTAINED within the eye itself. It is actually playing out in the brain. What you are SEEING is the processed image of nerve cells in your occipital lobe or the areas around the occipital lobes in the trajectory of the optic radiations which make it appear as if things are in the eye or wherever people think they are. They are in the brain. Secondly, you can't say, LEFT EYE....RIGHT EYE....in all likelihood the image being perceived and processed in the brain exists in BOTH visual fields since images and projections from EACH retina goes to form one optic pathway behind the crossover point called the chiasm....and so by the time things get back to the processing center....the signals being received are from BOTH retina on each side of the brain....bottom line.....these images you're referring to too called (SCOTOMAS) are not in an eye...nor can they be localized to only one EYE or the other....they are present within a VISUAL FIELD perhaps which can be further broken down in sharing the retinal projections from BOTH eyes! Now, that you're totally confused....next question! Aura typically last from 5-60 minutes when we are dealing with migraines. lol!
It's interesting that your aura only happen at work......don't take this the wrong way....but maybe you need a NEW BOSS...or perhaps a CHANGE OF SCENERY...if all your migraine aura pop up when you get to work. Stress is the #1 Trigger for all types of headaches combined.....I've never heard that statistic applied to just PURE AURA so I'd have to research that....Start looking for elements in your office environment such as chemicals, other substances that could be at your desk, in the air, perhaps they inject something into the RE-circulated air they probably pump around and around your office building??? I honestly don't have a great answer for you....except to say that if you really take NOTES and keep strict track of things you run across at the office....sooner or later you will run into the trigger for these events.....
There is such a thing as ACEPHALGIC MIGRAINE HEADACHES....which basically means....pure AURA without headache. Does that describe you? Do you have any type of cardiac valve anomaly or dysfunction? There is a high incidence of pure migraine aura and Mitral Valve Prolapse...seen mainly in women so...maybe? Have your cardiologist tell you about your heart valves and just the general status of your heart.....a routine EKG and echocardiogram may shed some light on this question.....
I still say your best bet is to talk to a HEADACHE SPECIALIST who really gets into headache diaries like I do.....COME AND VISIT ME in Cleveland! HA! Spring is coming and it should be a dandy, it should....we've got all sorts of incredible things for tourists to do....and I can give you a headache diary PERSONALLY! You're not that far away...seriously....Really, just think if you were coming from the planet Venus or XXXXXXX ...now that would be a hike for sure......
I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload images if you'd like.
Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback ESPECIALLY HAVING TO DO WITH MY SILLY JOKES! In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response. And don't forget to REOPEN the consult later when you want to ask me for the best time of year to come and visit our Fair City!
Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.
Many thanks for using this service to ask your questions. Be well.
This consult request has taken a total of 38 minutes of time to read, research, and respond.
P.S. It is considered just as important to TREAT AURA aggressively as if they were real live headaches. Just because there's no horrible headache doesn't mean you should be satisfied with living with these things......
Cheers!
You are most welcome for the response
Detailed Answer:
I have not heard of GERD so I will chat to my GP about getting a test done for it. Could this also cause the aura?
>>>>>>>>>>> No, GERD is not related to the type of aura you are experiencing...that is seen most typically for migraine headache presentations.
Regarding details of the aura, it is only in the left eye, and tends to be a vertical or slightly diagonal line of a rainbow of colours that wiggles / trembles. It is not exactly straight but a bit zig zaggy and it generally moves from the bottom to the top of the vision over a period of 20-30 minutes.
>>>>>>>>>>>>>>>>>>>>> About visual aura. The aura itself is NOT CONTAINED within the eye itself. It is actually playing out in the brain. What you are SEEING is the processed image of nerve cells in your occipital lobe or the areas around the occipital lobes in the trajectory of the optic radiations which make it appear as if things are in the eye or wherever people think they are. They are in the brain. Secondly, you can't say, LEFT EYE....RIGHT EYE....in all likelihood the image being perceived and processed in the brain exists in BOTH visual fields since images and projections from EACH retina goes to form one optic pathway behind the crossover point called the chiasm....and so by the time things get back to the processing center....the signals being received are from BOTH retina on each side of the brain....bottom line.....these images you're referring to too called (SCOTOMAS) are not in an eye...nor can they be localized to only one EYE or the other....they are present within a VISUAL FIELD perhaps which can be further broken down in sharing the retinal projections from BOTH eyes! Now, that you're totally confused....next question! Aura typically last from 5-60 minutes when we are dealing with migraines. lol!
It's interesting that your aura only happen at work......don't take this the wrong way....but maybe you need a NEW BOSS...or perhaps a CHANGE OF SCENERY...if all your migraine aura pop up when you get to work. Stress is the #1 Trigger for all types of headaches combined.....I've never heard that statistic applied to just PURE AURA so I'd have to research that....Start looking for elements in your office environment such as chemicals, other substances that could be at your desk, in the air, perhaps they inject something into the RE-circulated air they probably pump around and around your office building??? I honestly don't have a great answer for you....except to say that if you really take NOTES and keep strict track of things you run across at the office....sooner or later you will run into the trigger for these events.....
There is such a thing as ACEPHALGIC MIGRAINE HEADACHES....which basically means....pure AURA without headache. Does that describe you? Do you have any type of cardiac valve anomaly or dysfunction? There is a high incidence of pure migraine aura and Mitral Valve Prolapse...seen mainly in women so...maybe? Have your cardiologist tell you about your heart valves and just the general status of your heart.....a routine EKG and echocardiogram may shed some light on this question.....
I still say your best bet is to talk to a HEADACHE SPECIALIST who really gets into headache diaries like I do.....COME AND VISIT ME in Cleveland! HA! Spring is coming and it should be a dandy, it should....we've got all sorts of incredible things for tourists to do....and I can give you a headache diary PERSONALLY! You're not that far away...seriously....Really, just think if you were coming from the planet Venus or XXXXXXX ...now that would be a hike for sure......
I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload images if you'd like.
Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback ESPECIALLY HAVING TO DO WITH MY SILLY JOKES! In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response. And don't forget to REOPEN the consult later when you want to ask me for the best time of year to come and visit our Fair City!
Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.
Many thanks for using this service to ask your questions. Be well.
This consult request has taken a total of 38 minutes of time to read, research, and respond.
P.S. It is considered just as important to TREAT AURA aggressively as if they were real live headaches. Just because there's no horrible headache doesn't mean you should be satisfied with living with these things......
Cheers!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
