Kumar, Neeraj

Ipsilateral headache associated with hypoglossal nerve palsy is uncommon and is usually reported to be secondary to internal carotid artery dissection. Herein, we report three idiopathic cases of berign ipsilateral headache with hypoglossal nerve palsy.

The first description of what subsequently came to be known as the red ear syndrome (RES) was by Lance in 1994 (1) (Table 1, cases 2-4). Subsequently he reported a total of 12 patients with what he called the red ear syndrome (2) (Table 1). The syndrome was characterized by attacks of unilateral ear discomfort or burning during which the ear became red. The discomfort often extended beyond the ear. He reported an association with upper cervical disorders, glossopharyngeal and trigeminal neuralgia, temporomandibular joint (TMJ) dysfunction, and a thalamic syndrome. In two of the 12 cases (Table 1, cases 11 and 12) no cause was apparent. In some cases the episodes were spontaneous and in others they were precipitated by touch, exertion, heat or cold, neck movements, stress, cleaning the ear, washing hair or brushing it the wrong way, and eating or drinking. While some of their patients had a history of headaches (including migraines), a consistent relationship to migraine headaches was not identified.