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What Causes Pain Behind The Ear That Radiates Towards The Head?
Hi, My mother is 60+ and two weeks before she complained about an instance pain behind ear which is going towards back of the head, not completely back of the head , but the pain was moving from behind the ear towards back of head , and its a kind of off an on pain. We went to ENT Specialist and he said, Everything is ok and prescribed ETOVA-MR for 3 days twice a day, the tablet worked effectively but the little pain was still there, so we went to our family doctor who suggested to take Escitalopram 5mg once at night for 6 days, after taking two tablets of it my mother has the side effects like Dry mouth , body pain , loss of appetite and lose motions . Now we have stopped the latter medicine, but the side effects are not cured. Kindly consider the whole case and prescribe medicines for these side effects.?? Thanks
Sat, 7 Jul 2018
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.
I have gone through the whole symptoms you have described. I understood that your mother is suffering from a new onset of an episodic headache. To my knowledge, it looks like a condition called occipital neuralgia. It is a rare type of primary benign headache. Benign means not a serious condition. So don't get worried. I like to share more about occipital neuralgia.The term “neuralgia” refers to pain in the distribution of a nerve, in this case, the occipital nerves. Attacks are episodic and last a few seconds to minutes. Pain is piercing, stabbing, or sharp in quality, and severe in intensity. Sometimes it can be mistaken for a migraine, but a migraine headache is usually last longer. Occipital neuralgia usually diagnosed based on a thorough history and physical exam. The neurological exam will often be normal. By diagnostic criteria, the pain will be eased temporarily by injection of a local anesthetic along the affected nerve, but not always necessary. MRI or CT scan brain seldom required to rule out other harmful causes. I will suggest for your mother a conservative treatment including rest, periodic warm or cold compress, massage and physical therapy, directed at alleviating secondary muscle tension. If medications are necessary I recommend anti-inflammatory and muscle relaxant for temporary relief.
In severe cases, we use Carbamazepine, Gabapentin, Pregabalin, and Tricyclic antidepressants which tend to decrease the frequency and severity of attacks. Refractory cases some required nerve block or surgery. Regarding side effects you inquired, Yes Escitalopram can cause Dry mouth, body pain, loss of appetite. But diarrhea is not a side effect of Escitalopram. I suggest you discontinue the medication.On a cautious note, I like to say that as she is 60 yrs old, and new onset headache, if she is persisting with new bothersome symptoms doing brain imaging (MRI) is worth.
Hope I have answered your doubts. If anything else I will be happy to help.
Regards,
Mahendra T
I have reviewed your query and here is my advice.
I have gone through the whole symptoms you have described. I understood that your mother is suffering from a new onset of an episodic headache. To my knowledge, it looks like a condition called occipital neuralgia. It is a rare type of primary benign headache. Benign means not a serious condition. So don't get worried. I like to share more about occipital neuralgia.The term “neuralgia” refers to pain in the distribution of a nerve, in this case, the occipital nerves. Attacks are episodic and last a few seconds to minutes. Pain is piercing, stabbing, or sharp in quality, and severe in intensity. Sometimes it can be mistaken for a migraine, but a migraine headache is usually last longer. Occipital neuralgia usually diagnosed based on a thorough history and physical exam. The neurological exam will often be normal. By diagnostic criteria, the pain will be eased temporarily by injection of a local anesthetic along the affected nerve, but not always necessary. MRI or CT scan brain seldom required to rule out other harmful causes. I will suggest for your mother a conservative treatment including rest, periodic warm or cold compress, massage and physical therapy, directed at alleviating secondary muscle tension. If medications are necessary I recommend anti-inflammatory and muscle relaxant for temporary relief.
In severe cases, we use Carbamazepine, Gabapentin, Pregabalin, and Tricyclic antidepressants which tend to decrease the frequency and severity of attacks. Refractory cases some required nerve block or surgery. Regarding side effects you inquired, Yes Escitalopram can cause Dry mouth, body pain, loss of appetite. But diarrhea is not a side effect of Escitalopram. I suggest you discontinue the medication.On a cautious note, I like to say that as she is 60 yrs old, and new onset headache, if she is persisting with new bothersome symptoms doing brain imaging (MRI) is worth.
Hope I have answered your doubts. If anything else I will be happy to help.
Regards,
Mahendra T
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