When patients experience pain behind the ear, it may be due to local skin behind the ear with sebaceous cysts and secondary infection, or it may be related to inflammatory infection and peripheral neuralgia, as follows: 1. Sebaceous cysts and secondary infection: This can lead to local swelling, pain, and discomfort. 2. Inflammatory infection: Some patients may experience local lymph node inflammation and enlargement behind the ear, which is related to the surrounding skin 3. Peripheral neuralgia: Some patients may also experience paroxysmal pain behind the ear, which is often related to peripheral neuralgia. The patient may have excessive mental and emotional stress, anxiety, or recent restlessness, repeated fatigue, or late nights.