A Case of Nervus Intermedius Neuralgia

Onoda, Keisuke; Kawaguchi, Ai; Takaya, Yoshinori; Saito, Yuzo; Ishikawa, Hisashi; Uno, Takeshi; Miyamoto, Michiyuki; Oyama, Kenichi; Matsuno, Akira

doi:10.1016/j.wneu.2020.01.034

Cited by 8 publications

(29 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Note that the included cases are diagnosed as NIN, but this diagnosis may not have been confirmed and may not have even formally met ICHD‐3 criteria. As a result of this review, 61 papers were reviewed in full for inclusion, from which data on 127 cases were compiled from 33 publications, 2,6,8–38 with 30 of these publications discussing treatments 6,8–13,15–37,39 …”

Section: Methodsmentioning

confidence: 99%

“…The most common effective treatments reported in the literature were surgical procedures, 6,[8][9][10][11][12][13]15,16,18,[20][21][22]24,27,28,[30][31][32][33][34][35][36] including microvascular decompression, nerve sectioning, rhizotomy, and tractotomy. None of the surgical cases reported a poor response, although some did report requiring two to three procedures for a good response.…”

Section: Treatments Reported For Ninmentioning

confidence: 99%

“…Given the preponderance of surgical reports, focused information on medical treatment was vague and often limited. [8][9][10]13,[15][16][17][19][20][21][22][23][24][25][26][27]29,30,32,33,[35][36][37]…”

Section: Treatments Reported For Ninmentioning

confidence: 99%

“…A summary of the patient and clinical characteristics of the 127 NIN cases reviewed is shown in Table 1 2,6,8–38 . Cases were reported in all age groups (range 1–89 years, n = 102), with the mean age of occurrence being 45 years.…”

Section: Narrative Reviewmentioning

confidence: 99%

“…None of the surgical cases reported a poor response, although some did report requiring two to three procedures for a good response. Given the preponderance of surgical reports, focused information on medical treatment was vague and often limited 8–10,13,15–17,19–27,29,30,32,33,35–37 . Carbamazepine was the most commonly reported medication, with 18/30 responding and 12/30 having incomplete or no response.…”

Section: Narrative Reviewmentioning

confidence: 99%

See 4 more Smart Citations

A pain in the ear: Two case reports of nervus intermedius neuralgia and narrative review

Robblee

2021

Headache

View full text Add to dashboard Cite

Objective: Present two cases of nervus intermedius neuralgia (NIN) in which patients described unilateral deep ear pain as their primary complaint and present a summary of NIN cases reported in the literature. Background: The nervus intermedius is a tiny branch of the facial nerve that, with neuralgia, can present as a deep ear pain (NIN). The International Classification of Headache Disorders, 3rd edition, (ICHD-3) criteria for an NIN diagnosis include a unilateral deep ear pain with possible radiation that occurs in paroxysms with sharp pain and a tactile trigger. Methods: A PubMed search was conducted for NIN and geniculate neuralgia. Two patients recently diagnosed with NIN at a single clinic were selected for case reports to highlight the variability of symptom presentation. Results: The two cases reported here and the 127 cases reported in the literature show a wider range of presentations than included in the ICHD-3 criteria, including variable pain radiation sometimes diagnosed as concurrent trigeminal, glossopharyngeal, or occipital neuralgia. Pain was reported as constant or paroxysmal, as well as dull, sharp, or neuralgiform with inconsistent presence of triggers. While ICHD-3 does mention reported taste change, lacrimation, and salivation, the literature reports a much wider range of potential features associated with NIN. Optimal medical treatment is unclear given the predominance of surgical reporting of positive response to microvascular decompression, nerve sectioning, or other procedures. The two cases described here were successfully managed medically. Conclusion: NIN can present as described in the ICHD-3, but a more variable presentation may be possible. More studies are needed to clarify presentation, optimal medical treatment, and surgical indications for patients with NIN, especially when patients have no clear neurovascular conflict on neuroimaging. K E Y W O R D S ear pain, geniculate, nervus intermedius, neuralgia, otalgia | 415 HEADACHE How to cite this article: Robblee J. A pain in the ear: Two case reports of nervus intermedius neuralgia and narrative review.

show abstract

Section: Methodsmentioning

confidence: 99%