Nervus intermedius neuralgia, also known as geniculate ganglionitis or geniculate neuralgia, is a condition in which one experiences severe pain in the ear. The pain can come in different forms —whether it’s burning, stabbing or shooting — and attacks can be unpredictable in both their onset and their duration. When left unchecked, the disorder can be a serious hindrance to everyday life, so it’s important to seek the best treatment possible. Here is what my colleagues and I recommend for those suffering with nervus intermedius neuralgia.
Ensure a Correct Diagnosis
Nervus intermedius neuralgia is caused by the malfunction of the nerve signal pathways that connect the ear to the brain. The mechanics of the disorder can be complicated, so be sure to talk to an expert neurologist if you experience symptoms. It’s best to consult with a specialist who has experience with this disorder, as it is rare and not every doctor will know the best course of action.
Start Medication
Once you have been diagnosed with nervus intermedius neuralgia by a specialist, the first step is medication. The two most common medications are Tegretol and Trileptal, which are anticonvulsants used to decrease nerve signals and reduce your pain.
One of the benefits of these two medications is that unlike opioids, which are also commonly prescribed for pain, they are not addictive. They may cause side effects, however, such as drowsiness, fatigue or mental cloudiness. If these side effects persist even after you switch medications, you should consider surgery. Another reason to consider surgery is if your pain breaks through the highest allowed dose — this is known as breakthrough pain. Many patients report breakthrough pain, but the response to medication can vary depending on the patient, so it’s highly recommended that you give it a try.
Consider Surgery
If your nervus intermedius neuralgia side effects are too much of a burden, or if the medication simply isn’t working as intended, then you should consult a surgeon. Fortunately, there are many techniques used that have proven successful at reducing pain. Here are some of the most effective procedures for nervus intermedius neuralgia.
Microvascular Decompression/Nerve Sectioning
Microvascular decompression is a procedure intended to relieve compressive pressure on your nerve. The underlying concept of the surgery is that there is a blood vessel compressing your nerve and impairing its function. By creating space between the blood vessel and your nerve, the nerve is able to return to its normal function and thus reduce your pain. To be eligible for a microvascular decompression, you must have had a high-resolution MRI that demonstrates a blood vessel compressing your nerve. In other circumstances, the small nerve can be sectioned (cut) without significant complications. This often results in immediate relief of pain.
This procedure is recommended for young and healthy patients, as it is fairly invasive. Nonetheless, it is the preferred option, as it has the lowest rate of pain recurrence among all available surgical treatments for nervus intermedius neuralgia. It’s important to discuss your health with a surgeon to determine whether you are a good candidate for microvascular decompression.
Final Thoughts
Nervus intermedius neuralgia can be a debilitating condition, so be sure to seek out professional guidance as you decide on the proper course of treatment. It is important to be as informed as possible when considering your options. Above all else, we recommend consulting with an expert so that you choose the right treatment plan based on your health and lifestyle.
