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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 8999
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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Tingling in rt ear extending to rt shoulder? Trigeminal

Customer Question

Tingling in rt ear extending to rt shoulder? Trigeminal herpes zoster? Ramsay Hunt syndrome?
Submitted: 11 months ago.
Category: Neurology
Expert:  Dr. Frank replied 11 months ago.

Hello. Welcome to JA. How can I help? Herpes Zoster Otitis (Ramsay Hunt) is a severe pain syndrome with associated tinnitus/hearing loss and facial nerve paresis. You can have the rash form within the external ear canal, can have severe vertigo/gait imbalance. It comes on suddenly, and if that is the case, you need to go to the ER for a treatment with IV Steroids and Acyclovir. Please get back to me to discuss this further. If the pain is extending to the right shoulder area, yet started in the ear, it suggests high cervical root involvement (C2, C3), and then involvement of lower cervical roots/brachial plexus to include the upper shoulder area. Do you have a stiff neck/osteoarthritis of the cervical spine/cervical stenosis? Get back to me to discuss and I will reply. Dr Frank

Customer: replied 11 months ago.
I have cervical disc degenerative disease. Vicodin does not help with ear tingling ear pain but I have no rash
Expert:  Dr. Frank replied 11 months ago.

https://www.bing.com/images/search?q=trigeminal+nerve+distribution&view=detailv2&&id=73767CB5DDD59FEA16BDEF3D7ABEF4868E3A6BEA&selectedIndex=0&ccid=jh0LUpRt&simid=608039478713189102&thid=OIP.M8e1d0b52946d21a47d8655ceb1ea4a9fH0&ajaxhist=0

Customer: replied 11 months ago.
I did not get a response
Expert:  Dr. Frank replied 11 months ago.

So in case you don't know, the purple area is the sensory distribution for the superficial cervical plexus that comes off the cervical roots at the higher levels, the back of the skull/scalp comes off the greater occipital nerve which comes together as well off the higher cervical branches, C2 and C3 primarily, but they are the dorsal rami off those roots. The plexus runs down the neck and also into the supraclavicular fossa heading towards the shoulder. So I imagine that is the source of your pain/tingling sensation. Are you interested in medications for neuropathic pain? Pregabalin (Lyrica) would be a suggestion.

Expert:  Dr. Frank replied 11 months ago.

can you paste in that link for the drawing?

Expert:  Dr. Frank replied 11 months ago.

So in Ramsay Hunt. It is the facial nerve that takes the damage, and the pain is deep within the ear, as opposed to the outer parts of the helix of the ear and down the side of the neck.