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

Summary

A patient suffered an acoustic shock injury that caused no significant hearing loss but was followed by a cluster of chronic symptoms inside the ear (tinnitus, otalgia, tingling, tension, a red tympanic membrane) and outside it (blocked nose, neck/temporal pain). The authors propose these arise from a loop of middle-ear-muscle injury, peripheral inflammation, and activation/sensitization of the trigeminal nerve and autonomic nervous system with central feedback, a picture reminiscent of post-traumatic trigeminal-autonomic cephalalgia. It is the clinical illustration underpinning the tensor tympani, trigeminal model.

Key findings

• A real acoustic-shock case with normal hearing but the full symptom cluster in and around the ear.
• Signs point to middle-ear-muscle injury → peripheral inflammation → trigeminal and autonomic activation.
• Clinically resembles post-traumatic trigeminal-autonomic cephalalgia, linking ear symptoms to the trigeminal system.
• Single-patient observation, illustrative human evidence, not a controlled study.