Unexplained Ear Heat and Thumb Sensations: A Neurological Perspective

Q: Unexplained Ear Heat and Thumb Sensations: A Neurological Perspective

Hello： If your symptoms persist and tend to worsen, it is advisable to seek evaluation and treatment from a clinical physician. <br>You may consult an otolaryngologist or a neurologist. <br>Wishing you a speedy recovery.

Only my left thumb feels warm intermittently, and it's becoming more frequent?

Hello, Doctor.
Recently, both of my ears have been feeling very warm, but sometimes when I touch them, they don't feel hot.
I first visited my family doctor, who said that only my right ear was slightly inflamed and prescribed a three-day course of antibiotics.
After finishing the medication, the symptoms persisted.
A few days later, I went to see an otolaryngologist, who examined my ears, nose, and throat and found no issues.
They asked if I experienced dizziness, which I do, so they prescribed medication for "vertigo caused by inner ear issues" (though I have had dizziness for a long time; in previous instances of more severe dizziness, doctors suggested it could be due to anemia, stress, or possibly related to my ears, but I have not undergone any follow-up examinations.
I only received intravenous saline and medication for dizziness, and after resting for a while, my condition improved).
However, I only feel slight pain in my ears, but when it hurts, they feel warm, and the discomfort from the warmth is more pronounced (but the otolaryngologist said my ears are fine).
I would like to ask, my ears have been warm for two weeks now, and the warm sensation persists (especially around the ear canal and the area where the ear connects to the head), but the outer ear and earlobe are not necessarily hot.
Sometimes the warmth extends to my neck and cheeks, causing discomfort that makes me tear up (but I have no fever, cold, or cough).
Now, I also have episodes of warmth in my left thumb.
Doctor, what could this condition be? Is there an issue with my brain or nerves? Which specialist should I consult next? Thank you.

Miss Wang, 30~39 year old female. Ask Date: 2020/02/07

Dr. Hong Weibin reply Neurology

Hello: If your symptoms persist and tend to worsen, it is advisable to seek evaluation and treatment from a clinical physician.
You may consult an otolaryngologist or a neurologist.
Wishing you a speedy recovery.

Reply Date: 2020/02/07

More Info

The symptoms you are experiencing, including persistent heat in both ears, occasional pain, and sensations radiating to your neck and face, can be quite concerning. It's important to understand that these sensations may not always correlate with an underlying infection or inflammation, especially since your previous evaluations by both a general practitioner and an ENT specialist did not reveal any significant issues.

The sensation of heat in the ears, particularly when it is not accompanied by fever or other signs of infection, can sometimes be attributed to several factors, including:
1. Nerve Sensitivity and Irritation: The ears are richly supplied with nerves, and any irritation or inflammation in the surrounding areas (such as the jaw, neck, or even the scalp) can lead to sensations of heat or discomfort in the ears. This could be exacerbated by muscle tension, particularly if you have a history of stress or anxiety, which can lead to muscle tightness in the face and neck.

2. Vascular Changes: Emotional stress or anxiety can lead to changes in blood flow, causing peripheral blood vessels to dilate. This can result in a feeling of warmth or heat in the ears and face, even if the temperature of the skin does not reflect this sensation.
3. Eustachian Tube Dysfunction: The Eustachian tube helps to equalize pressure in the middle ear. Stress or tension can affect its function, leading to feelings of fullness or pressure in the ears, which might be perceived as heat or discomfort.

4. Neurological Factors: The sensation of heat in the ears, combined with the unusual warmth in your left thumb, raises the possibility of a neurological component. Conditions such as peripheral neuropathy or other nerve-related issues could manifest as abnormal sensations in various parts of the body.
5. Referred Pain: Sometimes, pain or discomfort in one area of the body can be referred from another area. For example, issues with the cervical spine or temporomandibular joint (TMJ) can lead to sensations in the ears.

Given the complexity of your symptoms, it would be advisable to consult a neurologist. They can perform a thorough neurological examination and may recommend imaging studies, such as an MRI, to rule out any underlying neurological conditions. Additionally, if muscle tension is suspected to be a contributing factor, a consultation with a physical therapist or a specialist in pain management may also be beneficial.

In the meantime, managing stress through relaxation techniques, such as mindfulness or gentle yoga, may help alleviate some of the muscle tension and associated symptoms. Staying hydrated and ensuring you have a balanced diet can also support overall nerve health.

In summary, while your symptoms are concerning, they may not necessarily indicate a serious underlying condition. A multidisciplinary approach involving both ENT and neurology specialists may provide the best pathway to understanding and alleviating your symptoms.

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