Back to Journals » Journal of Pain Research » Volume 10

A case report of complex auricular neuralgia treated with the great auricular nerve and facet blocks

Authors Eghtesadi M, Leroux E, Vargas-Schaffer G

Received 7 November 2016

Accepted for publication 10 January 2017

Published 17 February 2017 Volume 2017:10 Pages 435—438

DOI https://doi.org/10.2147/JPR.S126923

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Dr Michael Schatman

Video abstract presented by Marzieh Eghtesadi.

Views: 103

Marzieh Eghtesadi,1 Elizabeth Leroux,2 Grisell Vargas-Schaffer3

1Department of Pain Clinic, Headache Management, Centre Hospitalier de l’Université de Montréal (CHUM), Centre de Recherche de l’Université de Montréal (CRCHUM), 2Department of General Neurology, Headache Management, Centre Hospitalier de l’Université de Montréal (CHUM), Centre de Recherche de l’Université de Montréal (CRCHUM), 3Department of Anesthesiology, Pain Clinic, Centre Hospitalier de l’Université de Montréal (CHUM), Centre de Recherche de l’Université de Montréal (CRCHUM), Montreal, QC, Canada

Background: The great auricular nerve is a cutaneous branch of the cervical plexus originating from the C2 and C3 spinal nerves. It innervates the skin over the external ear, the angle of the mandible and the parotid gland. It communicates with the ansa cervicalis. Great auricular neuralgia is rarely diagnosed in clinical practice and can be refractory. We present a new approach using ultrasound-guided nerve blocks.
Case: We present a case of a 41-year-old female with paroxysmal ear pain accompanied by dysautonomia, tingling in the tongue, dysphagia, dysarthria and abdominal symptoms. No significant findings were found on cervical and brain imaging. The patient responded partially to a great auricular nerve block. A combined approach using this block with facet block of C2 and C3 induced a more pronounced and prolonged benefit.
Conclusion: Great auricular neuralgia is not often encountered in practice and can be accompanied by symptoms originating from the ansa cervicalis network. A combined approach of nerve blocks can be considered in refractory cases.

Keywords: ansa cervicalis, neuropathic pain, facet block, red ear syndrome, great auricular nerve

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]