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Nervus intermedius neuralgia

Ivan Garza, MD
Section Editor
Jerry W Swanson, MD
Deputy Editor
John F Dashe, MD, PhD


Neuralgia is a form of neuropathic pain that is characterized by the following features [1-3]:

Paroxysmal, brief (seconds to a few minutes), shock-like or lightning-like pain that follows a peripheral or cranial nerve distribution and can spread to adjacent areas in the course of the attack.

By definition, no objective neurologic deficits are found in the distribution of the affected nerve. (See "Overview of craniofacial pain".)

Attacks can be provoked by nonpainful stimulation (allodynia) of trigger points or zones.

A refractory period follows attacks; the duration of the refractory period shortens as the disease progresses.


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Literature review current through: Oct 2015. | This topic last updated: Nov 21, 2013.
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  1. Bruyn GW. Nervus intermedius neuralgia (Hunt). Cephalalgia 1984; 4:71.
  2. Peter, C, Watson, N. Trigeminal neuropathy and neuralgia. In: Neurological therapeutics: Principles and practice, Noseworthy, JH (Ed), Martin Dunitz, London, New York 2003. p.1849.
  3. Goodwin, JG, Bajwa, ZH. Understanding the patient with chronic pain. In: Principles and practice of pain medicine, Warfield, CA, Bajwa, ZH (Eds), McGraw-Hill, USA 2004. p.55.
  4. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33:629.
  5. Nurmikko, TJ, Jensen, TS. Trigeminal neuralgia and other facial neuralgias. In: The headaches, Olesen, J, Goadsby, PJ, et al (Eds), Lippincott Williams and Wilkins, Philadelphia, PA 2006. p.1053.
  6. Vytopil, M, Catalano, PJ, Jones, HR Jr. Cranial nerve VII: facial. In: Netter's Neurology, Jones, HR Jr (Ed), Icon Learning Systems, Teterboro, New Jersey 2005. p.112.
  7. Boes CJ, Copobianco DJ, Cutrer FM, et al. Headache and other craniofacial pain. In: Neurology in clinical practice, Bradley WG, Daroff RB, Fenichel GM, et al (Eds), Butterworth Heinemann, Philadelphia 2004. p.2055.
  8. Sakas DE, Panourias IG, Stranjalis G, et al. Paroxysmal otalgia due to compression of the intermediate nerve: a distinct syndrome of neurovascular conflict confirmed by neuroimaging. Case report. J Neurosurg 2007; 107:1228.
  9. Yeh HS, Tew JM Jr. Tic convulsif, the combination of geniculate neuralgia and hemifacial spasm relieved by vascular decompression. Neurology 1984; 34:682.
  10. Shah RK, Blevins NH. Otalgia. Otolaryngol Clin North Am 2003; 36:1137.
  11. Monstad P. Microvascular decompression as a treatment for cranial nerve hyperactive dysfunction--a critical view. Acta Neurol Scand Suppl 2007; 187:30.
  12. Smith JH, Robertson CE, Garza I, Cutrer FM. Triggerless neuralgic otalgia: a case series and systematic literature review. Cephalalgia 2013; 33:914.
  13. Pulec JL. Geniculate neuralgia: long-term results of surgical treatment. Ear Nose Throat J 2002; 81:30.
  14. Rupa V, Saunders RL, Weider DJ. Geniculate neuralgia: the surgical management of primary otalgia. J Neurosurg 1991; 75:505.
  15. Lovely TJ, Jannetta PJ. Surgical management of geniculate neuralgia. Am J Otol 1997; 18:512.