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Headache, Ear Pain, Pulsation Above Ear, ENT Found No Problems.

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Posted on Mon, 1 Oct 2012
Question: Hi Doc,
I am getting Headache on my left side above my ears since some days .

First it started with a ear pain around 3 months before for which i had consulted an ENT and got checked but there was no problem . He told me everything was fine and the pain will go and the pain went in few days .

After few months i again started to get the ear pain which goes on for some days and it will go and again comes back .

Yesterday i felt severe pain above my ear on the left side . I sometimes feel a pulsating feeling there. The pain i felt yesterday was little severe . It started after i came to office and it was there till noon .

Today also i had no pain in the morning but then around 9 a.m pain started which is mild .It always comes on my left side .

Other Details :

I am staying in AC room and the office also its AC sometimes is very cold .
I always used to attend telephone calls on left side .

My weight is 75 kg .
My age 25 years
doctor
Answered by Dr. Sumit Bhatti (1 hour later)
Dear XXXXXXX

Thank you for your query.

1. The location of your left sided pain above the ear, sometimes pulsating, is most likely due to spasm of the temporalis muscle - a fan shaped muscle in the scalp on the temporal bone. This muscle elevates and retracts the lower jaw.

2. This muscle and area including the left half of the face and the Temporo-Mandibular Joint (TMJ) is innervated by the Trigeminal Nerve (Fifth Cranial Nerve). Any inflammation or irritation in this area can be referred here.

3. Since this area is overlapped by Neurology, Dentistry and ENT, you will require multiple consultations to arrive at a diagnosis.

4. Since you do not have symptoms in the morning, it is unlikely to be related to clenching teeth in the night (bruxism). You may be inadvertently clenching your teeth near the AC or while on the phone (stress). Uneven dental bite may also be the cause.

5. Another common cause for such pain is migraine type headache. Do you have any family history of migraine? Does the pain change or worsen on movement or change of position? Is the throbbing (pulsating) at the temple region? Is the area tender on touch?

6. A dental splint usually relaxes the jaw and relieves the spasm.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sumit Bhatti (4 hours later)
Hi Doc ,

I was having queries related to which doctor i should consult . Should i go and check a dentist or a Neurologist ?

In our family there is no history of Migraine .
The pain does not change when we move or change position .
Both the sides are having the same feeling when touched .
Ya pulsation is on the temple region .

Thanking You
XXXXXXX
doctor
Answered by Dr. Sumit Bhatti (7 hours later)
Dear XXXXXXX

Thank you for writing back.

1. You may consult a Dentist first and then a Neurologist if there is no relief.

2. There are different types of Dentists. You should consult an Orthodontist. Orthodontists handle these kinds of problems.

3. Since both sides are tender, it is difficult to differentiate between a local and generalized cause without physical examination. An OPG (OrthoPantomoGram) X-ray may be advised.

4. Pulsations in the temple region are more in favor of anxiety and migraine type headaches. Other rare causes such as Temporal Arteritis are common only after the age of 50 years.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Headache, Ear Pain, Pulsation Above Ear, ENT Found No Problems.

Dear XXXXXXX

Thank you for your query.

1. The location of your left sided pain above the ear, sometimes pulsating, is most likely due to spasm of the temporalis muscle - a fan shaped muscle in the scalp on the temporal bone. This muscle elevates and retracts the lower jaw.

2. This muscle and area including the left half of the face and the Temporo-Mandibular Joint (TMJ) is innervated by the Trigeminal Nerve (Fifth Cranial Nerve). Any inflammation or irritation in this area can be referred here.

3. Since this area is overlapped by Neurology, Dentistry and ENT, you will require multiple consultations to arrive at a diagnosis.

4. Since you do not have symptoms in the morning, it is unlikely to be related to clenching teeth in the night (bruxism). You may be inadvertently clenching your teeth near the AC or while on the phone (stress). Uneven dental bite may also be the cause.

5. Another common cause for such pain is migraine type headache. Do you have any family history of migraine? Does the pain change or worsen on movement or change of position? Is the throbbing (pulsating) at the temple region? Is the area tender on touch?

6. A dental splint usually relaxes the jaw and relieves the spasm.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards