Very rare. Repeated attacks of uni - or bilateral redness of the ear, accompanied by burning pain and heat in the affected ear(s). Pain may spread to the cheek, behind the ear, forehead and neck. Pain may precede a migraine type headache or trigeminal neuralgia. While the primary forms associated with a cephalalgia, concern mainly young subjects, secondary forms, triggered by contact with the ear, a hot or cold beverage, occur in older patients.

The primary forms are a form of  paroxysmal-migraine type hemicrania or a trigemino-autonomic hemicrania (the term of auriculo-autonomic cephalalgia has been proposed by some authors). Secondary forms are related to spinal or cervical roots injury ( auriculotemporal nerve, temporomandibular joint) that could result in an antidromic discharge to the level of C3 root, explaining pain and vasodilation.

Anesthetic implications:

migraines ? Positioning of the neck if an involvement of C3 is suspected.

References : 

-        Boulton P, Purdy RA, Bosch EP, Dodick DW. 
Primary and secondary red ear syndrome : implications for treatment. 
Cephalalgia 2007; 27: 107-10.

-         Donnet A. 
Le syndrome de l’oreille rouge. 
Revue Neurol 2012 ; 168 : S2, PA216

-         Moitri MO, Banglawala SM, Archibald J. 
Red ear syndrome: literature review and a pediatric case report. 
Int J Pediatr Otorhinolaryngol 2015; 79: 281-5

Updated: October 2018