Red ear syndrome

Abstract

Red ear syndromeTo the Editor: As an addendum t o Dr. Lance's eloquent presentation of 12 cases of "red ear syndrome,"' I would add bilaterality and suggest the new name "red ears syndrome." Despite his case #8 (which was bilateral), Lance characterizes red ear syndrome as unilateral change in color with burning pain that may extend beyond the ear. In 1987 I studied 29 vascular or mixed vascular/ muscle contraction headache patients and 29 headache-free controls.2 Whereas 14 patients in the headache group and nine in the control group had frequent generalized facial blushing ( p = 0.11, five of the headache patients and none in the control group described frequent bright red discoloration of the ears independent of headache, not associated with auricular pain and not extending beyond the ear ( p = .05).As Lance indicated, parasympathetic vasodilation is greatest in the nose and cheek and least in the ear, implying that the isolated red ears seen in these headache patients were primarily mediated by inhibition of sympathetic vasoconstriction or activation of sympathetic vasodilation. Thus, the presence of "red ears syndrome" suggests an underlying dysregulation of sympathetic outflow in a subset of patients with cephalgia and may indicate a direction for potential treatment approaches.

Red ear(s) syndrome associated with child neuropsychiatric systemic lupus erythematosus

“…He did not have any apparent predisposing factor or etiology as described above. 6,7,9 However, even though it could not be a complete explanation, thalamic lesion would be the most probable cause of red ear(s) syndrome in this patient because our patient showed the vasculitis of left middle cerebral artery and infarction in left basal ganglia, which might involve the thalamus.…”

“…6 Hirsch reported the presence of red ear(s) syndrome in patients with headache, which may be caused by an underlying dysregulation of sympathetic out¯ow. 7 O'Gradaigh et al reported swollen tender indurated red ears and adjacent skin in antiphospholipid syndrome, which resulted from bilateral thrombosis of ears. 9 The etiology of red ears in our patient is obscure.…”

“…Hirsch also reported red ear(s) syndrome among patients with headache. 7 To our knowledge, however, there has not been any report of red ear(s) syndrome in SLE patients.…”

The red ear syndrome

“…The key clinical feature of RES is the presence of burning ear pain associated with marked ear reddening although Hirsch reported five patients with episodes of bright red discoloration of the ears not associated with auricular pain [18]. The erythema of the ear consistently follows the ear pain and usually lasts as long as the burning pain does.…”

Red ear syndrome

“…Other secondary pathologies have been associated with the syndrome, including Chiari I malformation, congenital anomalies of the cervical spine [14], herpes zoster virus infection of the C3-C6 dermatomes, and exercise-induced compression of the cerebellar tonsils [3]. Furthermore, the disorder need not necessarily result in significant ear pain, but rather only redness of the ear [4].…”