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75 year old female (my mother) has been suffering from

75 year old female (my...
75 year old female (my mother) has been suffering from SEVERE ear pain for 10+ years now. ENT Doc at hospital found absolutely nothing except a small hole in one ear drum. He also checked her throat and vocal cords with a camera down the throat and sinuses and found nothing. No fluid, no infection in ears. Her earaches get BAD when a change in weather, usually rain, is on the way and sometimes subsides after it has finished raining. She is in severe discomfort and no one can give any answer other than TMJ. She wears a partial, and this sometimes helps but not usually. Heat will help, motrin is starting not to have any effects on it. She does not grind her teeth. Cold air without ear muffs will also cause earache to start. She is on doxycycline (2nd round) for near pneumonia three weeks ago, after a Z-pack, and is not noticing any change in her ear. They have done a fungus test and it is negative. We are at a complete loss. Please help.
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Answered in 2 minutes by:
12/7/2017
Dr. Sohaib
Dr. Sohaib, Doctor
Category: Medical
Satisfied Customers: 4,915
Experience: MBBS, FCPS Experienced in all Medical Specialities
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Hello and thank you for the question.
Answers given are for informational purposes only and are not meant to replace an exam by an in-person.
I am Dr. Sohaib, a practicing Internal Medicine Consultant with over 13 years of clinical experience and I will do my best to help you today.

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Customer reply replied 8 days ago
I understand.

I can see that she had a very detailed evaluation done, and that was indicated.

Clearly the ear/throat evaluation fail to show any local cause for her pain.

I think that her Mystery Ear pain could be Neuropathic Referred Pain. This suspicion is based upon the fact that no clear reason from ear itself has been found that can cause the pain.

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Customer reply replied 8 days ago
She had a back surgery on L4 and L5 about five years ago, recovered 100%, no pain. She was injured years ago in the area between shoulder blades or a bit higher after being shoved off a cement porch. She does not complain of pain in this area, but could that possibly be a cause to request a scan/x-ray from her neurologist?

Referred pain in the nerve distribution (neuropathic pain) can give pain deep in the ear, in the tube, or outside /around the ear.

There are various nerves supplying different areas of ear both inside and outside; and irritation, compression, or neuropathy of any of these nerves can give her this pain. These kind of neuropathic pain are not responsive to usual pain medicine and need nerve soothers (like pregabalin or gabapentin) for controlling the pain.

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Customer reply replied 8 days ago
Alright thank you so much. The only other concern I have is should we go to her ENT with this, again, or should we go to her neurologist? Which would you recommend?

This can be coming from cervical area of spine so MRI of spine is a good idea here.

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I think you better discuss this with the ENT first and ask him for a medical report in which he should request a Neurologist to evaluate her for neuropathic pain, mentioning all the work up he has done and his failure to find an ENT related cause for this pain.

Dr. Sohaib
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Customer reply replied 8 days ago
Excellent. Thank you so, so much Dr. Sohaib, I appreciate your help so much. Have a great day/evening.

This will be helpful for the Neurologist to proceed further.

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Thank you and wish her speedy recovery.

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