My friend is frequently suffering from an outer ear pain these days. She told me that since she tends to catch a cold, it might be due to that. I fixed an appointment with an ENT yesterday, but surprisingly he told that she does not have any issues with her ear, nose, and throat. It might be a cold symptom. The cause of the pain could not be identified. Has it got something to do with any nerve syndromes as the doctor asked her to consult a neurologist or to perform a CT scan?
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Your friend has been taking Franxit (Amitriptyline, Chlordiazepoxide) for how long? Any anti-depressant medication should not be abruptly stopped, and all somatic symptoms and even fatigue, headache, and nervous instability could be related to sudden withdrawal also. Moreover, taking into consideration of outer ear pain, otitis external must be ruled out.
Does she have glue in the ear? Does she feel fullness inside the ear? Neurological problems related to the ear could be due to facial nerve insult due to virus -HZV (Ramsay Hunt syndrome) and there would be blisters in the ear which is less likely in her. Other than the above, I do not think any other neurological cause for the pain you mentioned. Does she complain of any face deviation? If not, no need to panic.
Sudden anti-depressant stopping.Differential diagnosis:
Facial palsy to rule out.Probable diagnosis:
Post antidepressant withdrawal.Treatment plan:
Resume Franxit and withdraw slowly for a period of six to eight weeks.Regarding follow up:
She may need a neurologist review to rule out seventh nerve paresis.
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