• Paolo P Picco, Matteo D'Alessandro, Massimiliano Leoni, Matteo Doglio, and Alberto Martini.
• Department of Paediatric Rheumatology, G Gaslini Institute, Italy.
• Cephalalgia. 2013 Nov 1;33(15):1277-80.

BackgroundRed ear syndrome (RES), first described by Lance in 1996 in an adult series, may be primary or associated with headache syndromes, upper cervical disorders or vascular anomalies. Clinically the disease is characterised by recurrent episodes of reddening and burning pain in the auricle, usually elicited by different triggers. The prevalence of RES in the paediatric age group remains poorly understood. Several therapeutic approaches have been tried with heterogeneous clinical response.Case ResultsWe report a paediatric patient suffering from primary RES associated with debilitating cochleo-vestibular symptomatology causing severe discomfort. Three years after the disease onset, the patient also developed headache, with clinical features of migraine.DiscussionThe temporal and spatial association could suggest shared pathogenetic features between neurological (cochleo-vestibular) and vascular (red and burning ear) symptomatology, likely related to trigeminal autonomic reflex activation, although further studies are required for full comprehension of RES pathogenesis.

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