Primary red ear syndrome associated with cochleo-vestibular symptomatology: a paediatric case report

Cephalalgia. 2013 Nov;33(15):1277-80. doi: 10.1177/0333102413493527. Epub 2013 Jun 25.


Background: Red ear syndrome (RES), first described by Lance in 1996 in an adult series, may be primary or associated with headache syndromes, upper cervical disorders or vascular anomalies. Clinically the disease is characterised by recurrent episodes of reddening and burning pain in the auricle, usually elicited by different triggers. The prevalence of RES in the paediatric age group remains poorly understood. Several therapeutic approaches have been tried with heterogeneous clinical response.

Case results: We report a paediatric patient suffering from primary RES associated with debilitating cochleo-vestibular symptomatology causing severe discomfort. Three years after the disease onset, the patient also developed headache, with clinical features of migraine.

Discussion: The temporal and spatial association could suggest shared pathogenetic features between neurological (cochleo-vestibular) and vascular (red and burning ear) symptomatology, likely related to trigeminal autonomic reflex activation, although further studies are required for full comprehension of RES pathogenesis.

Keywords: Red ear syndrome; carbamazepine; hearing loss; migraine; trigeminal autonomic reflex.

Publication types

  • Case Reports

MeSH terms

  • Analgesics, Non-Narcotic / therapeutic use
  • Carbamazepine / therapeutic use
  • Child
  • Ear Diseases / complications*
  • Ear Diseases / drug therapy
  • Erythema / complications
  • Erythema / drug therapy
  • Hallucinations / complications*
  • Hallucinations / drug therapy
  • Humans
  • Male
  • Migraine Disorders / complications*
  • Migraine Disorders / drug therapy
  • Pain / complications*
  • Pain / drug therapy
  • Syndrome


  • Analgesics, Non-Narcotic
  • Carbamazepine