are you there?
I am an adult neurologist, and will attempt to answer your question. You are offline, so please review the following information and ask questions if you have them , or if you are asked to answer my questions, please do so and I will return to reply. If you feel you have recieved enough information and are satisfied, please hit the accept button as that is how I am compensated for my work. If you have additional questions, even after you have hit the accept, for example you now have lab results, please return and I will be glad to answer your questions. Please be aware that as a physician I cannot make a diagnosis without an examination, so this is for information purposes only and does not adhere to the role of a patient-physician relationship. Ok?
so a sharp pain in the right temple,and that is all, no other neurological symptoms, visual complaints or symptoms, any flashing lights? nausea vomiting, light bothers you eyes? irritable? In a 31 year old woman, this is most likely a tension type headache or muscular contraction headache with pain from muscle spasm of the superficial temporalis muscle. There are other possibilities of course, like a vasculitis like syndrome with inflammation in the superficial temporal artery. but I would ask you to feel if there is a pulse directly under the sharp pain.
hi are you there?
hello the website just crashed a minute or two ago, so we might get disconnected if it happens again ok?
so do you have anything else you have noticed with the head pain?
ok, no prob. i was in a car accident 12 years ago, lost my hearing in my left ear, and since then these pains in my head have been happening. would there have been some nerve damage that could have caused this?
absolutely, that is probably exactly what it is, you have a neuralgia of a segmental nerve to your scalp
you damaged the nerve during the injury, probably demyelinated it or it lost its insulation in a spot, and now it acts up occasionally
does it come from just in front of your ear?
it could also be damage to the nerve that controls the vasospasm or reactivity of the superficial temporal artery, making it go into vasospasm and cause pain
if you feel just in front of your ear, you will feel a pulse, compare the right with the left
yes, mostly right at the temple on the right side
you lost hearing on your left side, and the pain in on the right?
at times it will be behind my ear and shoot down into my shoulder
check the pulses, ok?
yes that's right
the pain behind your ear is a neuralgia of the greater occipital nerve, I will sent you a webpage on that, take a look at it and let me know if it explains your problem
here is a couple of things, one is called chronic paroxysmal hemicrania, look at this, it is head pain from different nerves, but usually or always on one side only.
is there a way to reach you a little bit later? at work at the moment and i need to get back at it again :(
the next is greater occipital neuralgia, or a neuralgia of the nerve that gives sensation to the parietal or back side of your head, so you get wierd sensations on your scalp and pain in around the back of your head behind your ear
sure, just come back later, ok? bye
ok, thank you
Just find neuromd2012 if we lose this chat and we can start again Dr. Frank T
are you back?
yes, i have about 15 minutes
here is a nice article on GON (greater occipital nerve)
it shows you the distribution of the nerve and the block technique, you could consider trying this if it fits your problem
you have to consider vasculitis, like a rheumatological problem causing this, Rheumatoid arthritis, poly arteritis nodosum, inflammatory things like lyme disease, moyamoya disease, but it is all unlilkely if this vacillates and isn't progressive
i really don't have much more to add if you don't have questions and don't have other neurological symptoms other than the head pain
you can try some muscle relaxant type of meds like fioricet, have you tried that?
i just figured i'd give this a try. i've had all kinds of tests done years ago when it first started and nobody can find anything wrong. even my ear they say is ok, but there has to be a reason for being deaf in that ear
fioricet is for tension headache, it has a drug in it called butalbital that relaxes skeletal muscle on the side of your head if this is muscle spasm
absolutely, did you have brainstem auditory evoked potentials?
no i don't think so
well that is what you need with a good audiogram. go and see a good ENT doctor for your hearing loss
you probably have sensorineural loss, but you need it evaluated
that's who i did see...but, nothing
any good neurologist will test you at his office
ask around for a BAER's test ok?
ok, i'll have to track one down around here
good. let me know if I have answered your question ok?
you gave me a good direction to go anyway, thanks, XXXXX XXXXX all these pages you sent me and read them again later.
any good university speech pathology dept will do baers
great, hit the accept button ifyou are satisfied as that is how I get compensated for my work , ok? you can always come back with the record of your baer's and we can discuss it ok?
i will do that, thanks
you are welcome Dr. Frank T.
have a good day