[53F] Experiencing stabbing head pain, sore throat, and ear tenderness

Patient Description

A 53-year-old female presents with a 3-day history of stabbing pain on the right side of her head above the ear, rated 8 out of 10 in severity. The headache occurs several times an hour and is exacerbated by coughing, but it does not worsen with any specific activities. Heat application and ibuprofen provide some relief. She has experienced similar headaches in the past, but in different areas of the head. Additionally, she reports a 5-day history of a right-sided scratchy, red, and slightly swollen sore throat, which is not affected by the time of day and is accompanied by a dry cough. The patient also mentions tenderness and an ache in the right ear, which has been present for 3 days, and scalp tenderness when brushing her hair on the same side. There are no associated fever, chills, changes in vision, jaw pain while chewing, changes in the ability to smell or taste, sinus congestion, runny nose, or recent injuries to the ear.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Trigeminal Neuralgia: This is a chronic pain condition affecting the trigeminal nerve, which carries sensation from your face to your brain. It can cause severe, sudden burning or shock-like face pain that lasts anywhere from a few seconds to as long as 2 minutes per episode. The pain can be triggered by vibration or contact with the cheek (such as when brushing teeth, eating, or drinking), or even when speaking.

    • Treatment usually starts with medications, and some people may need surgery.
  • Temporal Arteritis: This condition causes inflammation and damage to blood vessels that supply the head area, particularly the large or medium arteries that branch from the neck. It can cause headaches, scalp tenderness, jaw pain, and vision problems. However, you did not report jaw pain or vision problems.

    • Treatment typically involves high doses of a corticosteroid drug.
  • Upper Respiratory Infection: Your symptoms of a sore throat, runny nose, and cough suggest a possible upper respiratory infection. This could be a common cold or flu.

    • Treatment usually involves rest, fluids, and over-the-counter medication to manage symptoms.
  • Otitis Media: This is an infection or inflammation of the middle ear. This can cause pain, a feeling of fullness, trouble hearing, and sometimes fever.

    • Treatment can include pain management and sometimes antibiotics.

What you can do

  1. For the headache, avoid activities that may trigger the pain, such as touching your face, brushing your teeth, or eating. Over-the-counter pain relievers may help.
  2. For the sore throat and cough, try over-the-counter remedies like lozenges or cough suppressants. Stay hydrated and rest as much as possible.
  3. For the ear pain, over-the-counter pain relievers may help. A warm compress on the ear may also provide some relief.

What you should look out for

Please seek immediate medical attention if you experience:

  • Sudden, severe headache or a headache that is accompanied by a stiff neck, fever, confusion, loss of consciousness, or seizures.
  • Symptoms of a stroke, such as sudden numbness or weakness in the face, arm, or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; or sudden severe headache with no known cause.
  • Severe ear pain or discharge from the ear.
  • Difficulty breathing or swallowing, or a sore throat that is severe or lasts longer than a week.

Remember, I'm an AI and this advice is not a substitute for professional medical advice. Please consult with a healthcare provider for an accurate diagnosis.

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9 mo ago


People Also Ask


What are the common symptoms of trigeminal neuralgia?

Trigeminal neuralgia is characterized by severe, sudden, shock-like facial pain that can last from a few seconds to two minutes per episode. The pain is often triggered by activities such as brushing teeth, eating, or speaking.


How is temporal arteritis diagnosed and treated?

Temporal arteritis is diagnosed through a combination of clinical evaluation, blood tests (such as ESR and CRP), and sometimes a temporal artery biopsy. Treatment typically involves high doses of corticosteroids to reduce inflammation.


What are the typical signs of an upper respiratory infection?

An upper respiratory infection often presents with symptoms such as a sore throat, runny nose, cough, congestion, and sometimes a mild fever. It is usually caused by viruses and can be managed with rest, fluids, and over-the-counter medications.


What are the symptoms and treatment options for otitis media?

Otitis media, an infection or inflammation of the middle ear, can cause symptoms like ear pain, a feeling of fullness in the ear, trouble hearing, and sometimes fever. Treatment may include pain management and, in some cases, antibiotics if a bacterial infection is suspected.


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