[44F] Experiencing ear pain and migraines

Patient Description

A 44-year-old female has been experiencing shooting pain in the ear and migraines for the past week. The ear pain occurs 3-4 times an hour, is described as a stabbing sensation originating from the mastoid area, and is accompanied by tenderness but no swelling. Her hearing has become muffled, and she has had migraines with aura every day, with intense pain on the right side of the head and visual disturbances. The migraines are rated 8 out of 10 in severity. She has a family history of migraines and cluster headaches. Her medical history includes congenital hiatus hernia, GERD, osteoarthritis, and hearing loss treated with hearing aids. She is allergic to erythromycin and naproxen and is currently taking cocodamol, brufen retard, ferrous fumarate, and omeprazole. No new medications have been started or stopped recently, and no side effects from current medications have been noted. She also takes multivitamins daily.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Migraines: You've mentioned experiencing migraines with aura, which are characterized by intense headaches often accompanied by visual disturbances. Your description of a "flashing kaleidoscope" in your eye is consistent with the visual aura that some people experience before or during a migraine. Migraines can sometimes be triggered by hormonal changes, stress, certain foods, or sensory stimuli.

    • Treatment for migraines often involves a combination of medications to relieve symptoms and prevent future attacks. Lifestyle modifications, such as stress management and avoiding triggers, can also be beneficial.
  • Mastoiditis: This is an infection of the mastoid bone, located behind the ear. Your description of shooting pain and tenderness in the mastoid area, along with muffled hearing, could suggest this condition. Mastoiditis often occurs as a complication of a middle ear infection.

    • Treatment for mastoiditis typically involves antibiotics, and in severe cases, surgery may be required.
  • Temporal Arteritis: This is an inflammation of the arteries in the temples and can cause headaches, scalp tenderness, jaw pain, and vision problems. It's more common in people over 50, but it can occur in younger individuals.

    • Treatment typically involves high-dose corticosteroids.

Please note that these are only potential diagnoses. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Schedule an appointment with your healthcare provider as soon as possible to discuss your symptoms. They may want to perform a physical examination and possibly order some tests, such as a blood test or imaging of your head and neck.

  2. In the meantime, try to manage your migraines by resting in a quiet, dark room, applying a warm or cold compress to your forehead or neck, and staying hydrated.

  3. Avoid known migraine triggers, if any.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen or you develop new symptoms.
  • You experience sudden, severe headaches.
  • You have sudden vision loss or double vision.
  • You have difficulty speaking or understanding speech.
  • You have difficulty swallowing or opening your mouth.
  • You have a fever or stiff neck.

Remember, I'm an AI and this advice is based on the information you've provided. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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9 mo ago


People Also Ask


What are the common symptoms of migraines with aura?

Migraines with aura often include visual disturbances such as flashing lights or zigzag patterns, followed by a severe headache. Other symptoms can include nausea, sensitivity to light and sound, and sometimes tingling or numbness in the face or hands.


How is mastoiditis diagnosed and treated?

Mastoiditis is typically diagnosed through a physical examination and imaging tests like a CT scan or MRI. Treatment usually involves antibiotics to clear the infection, and in severe cases, surgery may be necessary to drain the infection.


What lifestyle changes can help manage migraines?

Lifestyle changes that can help manage migraines include identifying and avoiding triggers, maintaining a regular sleep schedule, staying hydrated, managing stress through techniques like yoga or meditation, and eating regular, balanced meals.


What are the risks of untreated temporal arteritis?

Untreated temporal arteritis can lead to serious complications, including vision loss, stroke, or aneurysm. It is important to seek medical treatment promptly, which usually involves corticosteroids to reduce inflammation.


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