Nervus Intermedius and Geniculate Neuralgia

Manifestaciones clínicas del síndrome de Ramsay-Hunt en una serie de 20 casos

“…Casi simultáneamente aparece una otalgia severa de tipo quemazón, que evoluciona en forma de crisis, pudiendo irradiarse al área temporoparietal, occipucio e incluso faringe, de unos 2 a 4 días de duración y que también suele mejorar con la erupción vesicular [12]; aunque a veces es resistente a la analgesia habitual, prolongándose en estos casos el dolor, especialmente en los ancianos. La afectación simultánea del sistema nervioso autónomo hace que la otalgia se pueda acompañar de lagrimeo, congestión nasal e hipersalivación [22]. La erupción vesicular secundaria a la inflamación de la rama sensitiva auricular del VII, se localiza en el área de Ramsay-Hunt que comprende la concha, el conducto auditivo externo (CAE), la cara externa del tímpano y las zonas vecinas del trago, antitrago y antihélix [3,23].…”

Microvascular decompression of the posterior inferior cerebellar artery for intermediate nerve neuralgia

“…[ 8 ] In case reports and small series, long-term pain control has been observed after nerve sectioning or MVD, but no prospective studies on these methods exist. [ 11 18 ] The choice of surgical treatment was apparently based on the surgeon's personal experience and interpretation of the intraoperative findings, rather than on a firm preoperative diagnosis. [ 17 ] Because combined techniques were used rather arbitrarily, it is difficult to compare outcomes in and between studies.…”

Cranial nerves XIII and XIV: nerves in the shadows

“…It comprises visceral efferents comprised of preganglionic and parasympathetic fibers, which involve the submandibular and sublingual lacrimal glands as well as minor salivary glands. It is a short nerve, measuring no more than 21 mm in length 40,41. These efferents contact the pterygopalatine ganglion and pass through the base of the pterygoid process of the sphenoid bone, then extend into the pterygoid (vidian) canal, finally reaching the pterygopalatine fossa and developing synaptic connections with the homonymous ganglion 40.…”

“…For example, paroxysmal otalgia (lasting seconds or minutes), found in combination with alterations in lacrimation, salivation, and taste perception, is known as geniculate neuralgia, neuralgia of the intermediary nerve, or Tolosa-Hunt syndrome 4,40,41. Its causes may be different, ranging from malignancy to vascular compression, but are mainly idiopathic 3,41,43,44. Finally, it is important to consider the intermediary vein,39 which is adjacent to the intermediary nerve, which may alter the electrical function of this nerve in the event of anomalous venous drainage.…”