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excruciating head pains, worst at night, around right ear.
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excruciating head pains, worst at night, around right ear.

I have spells at night where I get excruciating head pains, around right ear, lasting about 10 - 30 seconds, very painful when i touch the area. It usually goes away when i get up. They are becoming more often. I also have headaches and head pain, most days anymore. I had a blow to my head about 2 years ago. Saw a family Dr. about the pains, he thought it could be fybromiyalga, or stress or both. Have never seen a specialist about it. Concerned with the blow to head if this could be an anerisym? I keep some sort of head pain in that area all the time now. Definately worse at night, and especially when I lay on the right side of my head.
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

There are several causes of headaches. Headaches can be divided into primary and secondary. Primary headache disorders are headaches without a direct cause. These are diagnosed after secondary causes have been excluded. Secondary headache disorders are due to an underlying problem, there are many many causes but some include medication side effects, systemic illness, nervous system infection, tumors, bleeds in the brain or clots in the veins of the brain, and others.

In your case, the fact that your spells occur at night is concerning, and a secondary cause would need to be excluded with imaging such as an MRI of the brain. However, there are several primary headache disorders or other pain symptoms that could explain your symptoms. Your daily headaches could be migraines, which usually a pulsating throbbing one-sided pain with nausea and discomfort in bright lights that lasts several hours, though there are several other potential causes. The fact that the area around your ear is sensitive to touch suggests this could be trigeminal neuralgia, a kind of irritative lesion to the nerve that supplies innervation to the face, the trigeminal nerve. Another type is cluster headaches, which are sharp pains that occur around and behind the eye but can be as far back as the temple area, often at night and are associated with tearing of the eye and running of the nose. In primary stabbing headache, sharp or jabbing pain in the head occur, either as a single stab or a series of brief repeated volleys of pain. Primary stabbing headache often occurs in people with migraine. As you can see, there are many potential causes to your headache. Another headache that can cause a chronic pain with superimposed sharp pains is hemicrania continua.

While it is possible that this is fibromyalgia and stress, before these diagnoses are made, further evaluation, particularly if you have not had imaging of your brain, is warranted. Many of the headache types discussed above, and other headache types, are treatable with medication. Evaluation by a neurologist is recommended. Evaluation by a headache specialist (a neurologist with specialization in headache medicine) may be of particular benefit to you if you have one in your area.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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