Nervus Intermedius (or Geniculate Neuralgia)

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Nervus Intermedius (or Geniculate Neuralgia)

The following article is excerpted from:

THE MANAGEMENT OF PAIN,

VOL 1, Second Edition, 1990, Lea & Febiger, Philadelphia]

CRANIAL NEURALGIAS

D. Loeser

Nervus intermedius neuralgia sometimes known as or Geniculate Neuralgia

is an extremely uncommon pain syndrome in which the patient reports

shock-like pains in the distribution of the nervus intermedius, which is

the somatic sensory branch of cranial nerve VII. The pain is in every

way similar to that of tic douloureux except for its location. Few cases

have been reported since the origin report by and in 1909.

Symptoms and Signs

The patient complains of intermittent stabbing pain, like electric

shock, deep in the ear. The pain can be triggered by non-noxious

stimulation of the ear canal or can follow swallowing or talking. The

patient is pain free between attacks. Neurologic deficits are absent.

The syndrome is always unilateral. Some patients have reported,

salivation, bitter taste, tinnitus, and vertigo during the pain attacks;

perhaps this indicates involvement of central connections of the nervus

intermedius or irritation of other components of cranial nerves VII and

VIII. Rarely, patients with pain in the trigeminal distribution also

have pain in the nervus intermedius territory.