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Front Neurol. 2017 Aug 16;8:420. doi: 10.3389/fneur.2017.00420. eCollection 2017.

A Case of Acoustic Shock with Post-trauma Trigeminal-Autonomic Activation.

Author information

1
Service ORL et CCF, Hôpital Européen G. Pompidou, Paris, France.
2
Faculté de médecine de Nancy, Université de Lorraine, Nancy, France.
3
Lycée Germaine Tillion, Académie de Lyon, Sain-Bel, France.
4
Laboratoire Neurosciences Intégratives et Adaptatives, UMR CNRS 7260, Fédération 3C, Aix-Marseille Université, Marseille, France.

Abstract

This study reports the case of an acoustic shock injury (ASI), which did not result in a significant hearing loss, but was followed by manifold chronic symptoms both within (tinnitus, otalgia, tingling in the ear, tension in the ear, and red tympanum) and outside the ears (blocked nose, pain in the neck/temporal region). We suggest that these symptoms may result from a loop involving injury to middle ear muscles, peripheral inflammatory processes, activation and sensitization of the trigeminal nerve, the autonomic nervous system, and central feedbacks. The pathophysiology of this ASI is reminiscent of that observed in post-traumatic trigeminal-autonomic cephalalgia. This framework opens new and promising perspectives on the understanding and medical management of ASI.

KEYWORDS:

acoustic shock; inflammation; otalgia; pain; referred pain; tinnitus and hyperacousis; trigeminal nerve

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