Trieminal Nerve and Ear Infection

[jerasson]

I would most appreciate some feedback on my case that has baffled my ENT Dr. and the neurologist. I am a healthy male at age 60:

Symptom:
• Started with what looked like outer ear infection left side only. That did not go away for 3 weeks, then inflammation of middle ear. I had the usual ear ache but little or no pus or discharge. We used antibiotic ear drops.
• Started to feel some light symptom of trigeminal neuralgia. This was on and off
• The ear inflammation persisted with some tinning and conductive hear loss
Diagnosis process:
• After 6 weeks we did a temporal bone CT scan. Negative results. Some inflammation in middle ear.
• After 8 weeks, we did a biopsy and culture of outer ear. All negative just chronicle inflammation.
• The trigeminal neuralgia increase in intensity. Constant pain in the jaw and cheek. I saw a young neurologist who said that he can give me medication for the trigeminal neuralgia. I refused until we find what is causing this and what its relation to the ear infection is. The neurologist ordered an MRI we think will be negative, but we want to be sure.
• I just started to feel like some sun burn on right side of the scalp. Which the other side of where I have the persistent ear infection and the more classical trigeminal neuralgia. The feeling on the scalp is very light and it is gone now on its own.
My ENT is very concerned now. He consulted with other physicians and suggested that the next step is exploratory surgery behind the ear to get culture, biopsy, etc.
Questions:
I am hoping that the two problems are related. So if we find an answer for the cause of the trigeminal neuralgia, then it would be the same for the ear problem.
1. Could the trigeminal neuralgia be caused by a viral infection, if so what are the most common virus
2. Can a middle ear inflammation cause pressure on the trigeminal nerve that would result in trigeminal neuralgia
Thank you very much. Please also ask an ENT specialist to see if we have a common cause.
Thank you very much
Note of Interest:
My ENT wants to treat me for Tuberculosis Otitis Media because had an exposure to TB when 55 years ago and I have a positive skin test but. My ENT suspected TB in the middle ear. I just did a chest CT scan and it is negative. I also do not have any other known related symptoms as described below.
“Classically, tuberculous otitis media is described as having an insidious onset with painless otorrhea, multiple tympanic membrane perforations, abundant pale granulation tissue in the middle ear, early severe hearing loss out of proportion to clinical findings, and bone necrosis. However, the current literature indicates most patients actually present with a single perforation. Indications of tuberculous otitis media include hearing loss out of proportion to clinical findings, failure to respond to the usual medical therapy, post-mastoidectomy recurrence of granulation tissue, slow wound healing, persistent otorrhea, and the formation of bony sequestra”

As I mentioned above the biopsy of the outer ear showed no bacteria in general and not TB bacteria.




This discussion is related to Re: Trigeminal Neuralgia.