A pain in the ear: Two case reports of nervus intermedius neuralgia and narrative review.
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| Title: | A pain in the ear: Two case reports of nervus intermedius neuralgia and narrative review. |
|---|---|
| Authors: | Robblee, Jennifer |
| Source: | Headache: The Journal of Head & Face Pain. Mar2021, Vol. 61 Issue 3, p414-421. 8p. |
| Subjects: | Herpes zoster, Earache, Facial neuralgia, Facial nerve |
| Abstract: | 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. [ABSTRACT FROM AUTHOR] |
| Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 149452517 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: A pain in the ear: Two case reports of nervus intermedius neuralgia and narrative review. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Robblee%2C+Jennifer%22">Robblee, Jennifer</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Headache%3A+The+Journal+of+Head+%26+Face+Pain%22">Headache: The Journal of Head & Face Pain</searchLink>. Mar2021, Vol. 61 Issue 3, p414-421. 8p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Herpes+zoster%22">Herpes zoster</searchLink><br /><searchLink fieldCode="DE" term="%22Earache%22">Earache</searchLink><br /><searchLink fieldCode="DE" term="%22Facial+neuralgia%22">Facial neuralgia</searchLink><br /><searchLink fieldCode="DE" term="%22Facial+nerve%22">Facial nerve</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: 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. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=149452517 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/head.14066 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 414 Subjects: – SubjectFull: Herpes zoster Type: general – SubjectFull: Earache Type: general – SubjectFull: Facial neuralgia Type: general – SubjectFull: Facial nerve Type: general Titles: – TitleFull: A pain in the ear: Two case reports of nervus intermedius neuralgia and narrative review. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Robblee, Jennifer IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 03 Text: Mar2021 Type: published Y: 2021 Identifiers: – Type: issn-print Value: 00178748 Numbering: – Type: volume Value: 61 – Type: issue Value: 3 Titles: – TitleFull: Headache: The Journal of Head & Face Pain Type: main |
| ResultId | 1 |
