Diagnosis: Drug Dependent Cluster Headaches...but now other issues.. ?

[HeadHurts76]

I was diagnosed 18 months ago w/ drug dependent cluster headaches (localized to front right temple 90% of the time) due to an overuse of naproxen sodium (old sports injuries).  I finally went to the doc after I had a headache for 2 weeks straight and the vision in one of my eyes 'smeared'....scared the hell out of me.  Got an MRI....while waiting for the results, I had an episode that I described to the doctors and they agreed was a local seizure in my right arm.  The MRI turned up a very small pineal cyst.  My Neurologist and a Neurological Surgeon that I spoke w/ both agreed that this could not be the cause of my issues as it was smaller than a pea...that we went fishing for something and found something....I'm getting annual MRIs to monitor it.  I got an EEG but it turned up clean.  I'm taking 150mg of Topomax and 200mg of Lamictal a day and occasionally a 10mg Maxalt to keep the headaches (and I guess seizures) at bay.  If I didn't have these drugs the headaches are 24/7/365 and are completely unbearable...I would give it 6 months before I would be in a looney bin.

So there's the history.  Now...I have an ear infection in my right ear that won't go away.  It's been 6 weeks now.  I've got about 20% of my hearing, constant ringing...it's very frustrating.  The ENT is ready to stick the tubes in but I'm starting to wonder if there's a multi-symptom pattern....I seem to have lots of issues from the neck up on the right side of my head!  I'm wondering if this could be something like TMJ?  I had a lot of catch-up dental work done a couple of years ago...like 9 cavities and a root canal....not sure if they could be related?  My questions is this....I'm going to go see my Neurologist next week before I let my ENT start cutting on my ear; Is there anything I should be asking/bringing up?...does anything look suspect?  Thanks for any help you can provide....I need my brain in my line of work and I'd love to get off of all these pills.

[PaulMD]

Hi there.

Your recurrent ear infections may be due to some anatomic problems in the development of your ears and to a structure called eustachian tubes (the tubes that connect your middle ear to the nasal cavity).  Problems with this tubes will cause inadequate drainage of middle ear fluids that makes it prone to infections.  Your ENT plan of putting a tympanic tube sounds appropriate.  I seem can't find a strong correlation with your present problems with the previous ones, I also doubt if this has something to do with TMJ.  

I hope that your ear problem will get fixed soon, and the pain would be adequately controlled.  Take care and God bless.