Severe pain in temples

I have a question about a horrible pain I have experienced ever since adolescence. It is triggered by the wind on my ears. The colder the air, the faster the onset of pain. And, if my ears are wet from swimming and there is a breeze, it happens. It feels like an ice pick is going through my temples, always both temples at the same time. The pain is just awful. It makes me dizzy. Sometimes, I'll stagger as I walk away from the pool. Luckily, it subsides within minutes of warming my ears.

I wouldn't say I had TN until last year with the onset of my current symptoms, which are different. BUT, some people describe pain like that of being stabbed by an ice pick. AND, the pic on Wikipedia of the trigeminal nerve does show the first branch as being up by the temples. Could this be a TN issue?

My neuro said that it is not, but he offered no other explanation. Also, I don't know how much my neuro really knows about TN as I have only seen him twice.


Hi Christi,

I also have and get that pain, and to be honest I think it's the worst of the pains I get. Outdoors in any breeze, I always try and cover my ears somehow, and I've avoided swimming for years now. Sadly, swimming used to be my favourite thing :(

Mine too feels like an ice pick - but switches between repeated stabbing sensation or just like the ice pick is lodged in my temples. It is one of very few pains I get that will always drop me to the floor very literally.

To answer your question of the temples being on the trigeminal nerve - very much YES. Behind the temple bone also is where the Trigeminal Ganglion lies, the centre from where each of the three main branches stem from. I know this from my pain clinic specialist from where he's done different kinds of nerve blocks - he explained all this anatomy to me.

My Neurologist, well now ex-Neuro is an idiot and really didn't know anything about TN, I often figured I knew more about TN than he did. An often we do until we find the really good Neuro's who have studied and know and listen to us.

TN takes many forms, presents pain in different ways. I was diagnosed at age 30 after already suffering a multitude of face pain symptoms since age 17. But even since age 30, when I learnt what TN was (I'm now 37) I would have to say the range of pain sensations still continues to shock and surprise me. They are: zaps, cattle prod, stabbing, drilling, wrenching, twisting, burning :( , the ice pick, creepy crawlies, pressure bands, one that feels like insect stings of the worst kind and so on ......

If you experience the pain in your temples on both sides at once, that is a curiosity - Christi, do you have TN on just one side of your face or both? I have it on both sides - and though every doctor says TN can only attack on one side at a time - I know that is not true, as I have had attacks of TN on both sides simultaneously and it's a nightmare.

When the temple pain is involved these days, it also includes both my ears, and one upper cheekbone, directly below the eye. It is the worst and longest lasting pain I get, the pain lasting never less than 12 hours - the longest single running attack going for up to 2 days, before I get driven half mad from the intense pain and lack of sleep and go to the ER.

To think alternately, the Occipital nerve at the back of your neck runs up and around the sides of your head, partly over the scalp and into the ears, running past the temoral bone. Unfortunately, I have this as well. It too is on both sides of my neck, so I have both bilateral TN & bilateral ON. The Occipital pain will almost always trigger my TN pain due to the proximity of the nerves where they pass near the temporal bone and THIS is a nightmare for me.

Can I answer anything more specifically for you Christi?

Best wishes for a pain free days ahead!

Kerry xx

With simultaneous pain in both temples, consistently initiated by a cold wind in the ears, the issue might not be one of TN or ATN, even though the same nerve may be involved. I think you may need to be evaluated by a better trained neurologist for a disorder called "cluster headache". The classic "ice pic" pain symptom is often associated with that disorder.

Go in Peace and Power

Red Lawhern, Ph.D.

Hi Christi

The nerve to the temple is in the 1st branch of the trigeminal nerve, like you said, so it's certainly a "neuralgia". Since it's on both sides, it would be classed as atypical trigeminal neuralgia. Many people have trigeminal pain on both sides. I've had cluster headaches, and they cover a much bigger area than only the temple. I have had this problem since I was a little girl (getting in the cold and my temples feel the stabbing and my eyes water). I live in a cold, windy area so I am stuck inside most of the winter. Lately I found a group here about fashion for TN which has different fashions you can wear on your head to protect it from the cold and wind. You might want to go to the top of this page, the line across the top that says "main, my page, discussions, " etc. and go to "more", then down to groups. Look for one with the word "fashion". You don't have to join it to look at it. You might want to look at other groups there that interest you. That's where the friendships are made. There is a lot of info on this site when you look around in the discussions and groups.

Since you mention you have new and different symptoms as well, I hope your neurologist can at least understand that it is a neuralgia, most likely trigeminal, because your pain is in the trigeminal nerve; and treat you with neuralgia meds. I really dislike the neuralgia meds, so I use a lot of alternative/natural methods. The pain you speak of turned into full TN for me 14 years ago.


Oh, Kerry, thank you for such a thorough response. I think you know exactly the kind of pain I feel in my temples with the same triggers. I only get in the pool on a breezy day knowing the pain I'll face for two reasons: to make my kids happy and because I know the pain will pass within 5-10 minutes. I cannot imagine the pain load you are bearing! May I never know.

Yes, my ATN is bilateral with the majority of the pain on one side (thank goodness!) I also feel the pain in my ears as you do, but the temple pain overshadows that by far--I never really considered the ear pain until you mentioned it. I usually sit and hold my ears until the head pain subsides. I'm sure I look completely ridiculous!

Thank you again for your input. I hope this note finds you enjoying a pain-free day. (hug)


Red, thank you for your reply. I will do some research on cluster headaches. I know nothing about them.


Hi Christi,

That sounds like cluster head aches to me, and sinus issues can also effect both temples. TN can be bilateral but usually not at the same time. Since your feeling the pain in both temples at the same time like cluster head aches doo it may be worth asking about. You may have symptons from both. I am sorry your neuro wasn't willing to help you further. I would check with an ENT doctor as well.

Hugs and prayers,


I just read the other posts now and see they are thinking the same thing lol great minds :)

Well, I've done some research, and I can easily rule out cluster headaches. I'm experiencing something very different. And, thank goodness! Cluster headaches sound frightening!


Anna and Tracy,

Deep, stabbing pain in the ear can be either an inner ear infection or another form of neuralgia called "Geniculate" Neuralgia. It isn't absolutely clear that this type of pain is actually a neuralgia (inflammatory process) at all. It might also be a form of neuopathy caused by nerve compressions, just as typical(Type 1) " TN" is. In any event, the treatments for Geniculate Neuralgia tend to be the same as for TN. Cluster is a different beast and even harder to treat. The following link from Mayo Clinic outlines some of the options for treatment:

Regards and best,


ChristieI to have lot’s of problems with my ear’s they do cause my balance to make me feel dizzey and vertigo I had lot’s more severe pain in them some has calmed down from time to time then I have my trigger’s that set’s my face pain and ear’s hurt (a lot more). I do get migraines also my doc said it sounded like a ice pick headach or pain on side of head near temple’s. When that hit’s It’s extremley pain ful I cant even move just hold my head and go lay down. I 've had a coulple of these dont know when it hit’s but when it does I know Why he called it that very painful and draining.I alway’s blamed my dizziness on med’s, Im not so sure of that cause Even now that I cut back on my med’s Im sure some of this is just from the pain.And also I had some attact’s on both side’s of my face. (Kerry) and christie. The pain seem’s to be stronger on right Maybe due to TMJ. but I’ve had attack’s on both side’s severe. Prayer’s Sent Shirely