This case report demonstrates an uncommon, symptomatic elongated styloid process that did not conform to the usual clinical features. The patient was under 30 years of age when the symptoms appeared. He experienced the classic symptoms without prior tonsillectomy; he also experienced carotid artery syndrome symptoms. However, the patient did receive the common diagnosis seen in many cases of unexplained chronic head and neck pain. He was simply labeled a psychotic with no just cause for pain.