PMC5711775_01
Timeline of patient's clinical history from childhood to daith piercing insertion.
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F1
His clinical history is summarized in Figure 1.
(A) Patient's left ear with daith piercing located at the crus of the helix. (B) Shows the possible mechanism of action of daith piercing: a nociceptive sensory stimulus provided by daith piercing activates vagal afferents which, through the nucleus tractus solitarii (NTS), exert an inhibitory action on neurons in the caudal trigeminal nucleus; vagal activation can also modulate pain perception by means projections from NTS to the locus coeruleus and to the nucleus raphe magnus.
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F2
Since the repeated therapeutic attempts led only to minimum benefit, in March 2016, the patient decided, on his own free will, to get a "daith piercing," which is an ear piercing located at the crus of the helix (Figure 2A), bilaterally.