Geniculate neuralgia

Clinical, radiologic, and intraoperative correlates

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: Geniculate neuralgia is an uncommon pain syndrome that can be severe and disabling and is difficult to diagnose. Methods: The literature was reviewed for geniculate neuralgia, including anatomy, presentation, and treatment. A case illustration was presented that demonstrates the novel brainstem functional imaging findings for geniculate neuralgia. A 39-year-old man presented with a history of left "deep" ear pain within his ear canal. He noted occasional pain on the left side of his face around the ear. He had been treated with neuropathic pain medications without relief. His wife described suicidal ideations discussed by her husband because of the intense pain. Results: The patient's neurologic examination was normal, and otolaryngologic consultation revealed no underlying structural disorder. Anatomic imaging revealed a tortuous vertebral artery-posterior inferior cerebellar artery complex with the posterior inferior cerebellar artery loop impinging on the root entry zone of the nervus intermedius-vestibulocochlear nerve complex and just inferior to the root entry zone of the facial nerve and a small anterior inferior cerebellar artery loop interposed between the cranial nerve VII-VIII complex and the hypoglossal and glossopharyngeal nerves. A left-sided retromastoid craniotomy was performed, and the nervus intermedius was transected. An arterial loop in contact with the lower cranial nerves at the level of the brainstem was mobilized with a polytetrafluoroethylene implant. Conclusions: The patient indicated complete relief of his preoperative pain after surgery. He has remained pain-free with intact hearing and balance.

Original languageEnglish
JournalWorld Neurosurgery
Volume80
Issue number6
DOIs
StatePublished - Dec 2013

Fingerprint

Herpes Zoster Oticus
Pain
Vestibulocochlear Nerve
Arteries
Facial Nerve
Spouses
Brain Stem
Ear
Glossopharyngeal Nerve
Hypoglossal Nerve
Suicidal Ideation
Ear Canal
Vertebral Artery
Cranial Nerves
Craniotomy
Neurologic Examination
Polytetrafluoroethylene
Neuralgia
Hearing
Anatomy

Keywords

  • Geniculate neuralgia
  • Magnetic resonance imaging
  • Nervus intermedius
  • Posterior fossa surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Geniculate neuralgia : Clinical, radiologic, and intraoperative correlates. / Tubbs, R. Shane; Mosier, Kristine; Cohen-Gadol, Aaron.

In: World Neurosurgery, Vol. 80, No. 6, 12.2013.

Research output: Contribution to journalArticle

@article{3fecf2a5c0c0430d85aa3fee1b03275a,
title = "Geniculate neuralgia: Clinical, radiologic, and intraoperative correlates",
abstract = "Objective: Geniculate neuralgia is an uncommon pain syndrome that can be severe and disabling and is difficult to diagnose. Methods: The literature was reviewed for geniculate neuralgia, including anatomy, presentation, and treatment. A case illustration was presented that demonstrates the novel brainstem functional imaging findings for geniculate neuralgia. A 39-year-old man presented with a history of left {"}deep{"} ear pain within his ear canal. He noted occasional pain on the left side of his face around the ear. He had been treated with neuropathic pain medications without relief. His wife described suicidal ideations discussed by her husband because of the intense pain. Results: The patient's neurologic examination was normal, and otolaryngologic consultation revealed no underlying structural disorder. Anatomic imaging revealed a tortuous vertebral artery-posterior inferior cerebellar artery complex with the posterior inferior cerebellar artery loop impinging on the root entry zone of the nervus intermedius-vestibulocochlear nerve complex and just inferior to the root entry zone of the facial nerve and a small anterior inferior cerebellar artery loop interposed between the cranial nerve VII-VIII complex and the hypoglossal and glossopharyngeal nerves. A left-sided retromastoid craniotomy was performed, and the nervus intermedius was transected. An arterial loop in contact with the lower cranial nerves at the level of the brainstem was mobilized with a polytetrafluoroethylene implant. Conclusions: The patient indicated complete relief of his preoperative pain after surgery. He has remained pain-free with intact hearing and balance.",
keywords = "Geniculate neuralgia, Magnetic resonance imaging, Nervus intermedius, Posterior fossa surgery",
author = "Tubbs, {R. Shane} and Kristine Mosier and Aaron Cohen-Gadol",
year = "2013",
month = "12",
doi = "10.1016/j.wneu.2012.11.053",
language = "English",
volume = "80",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Geniculate neuralgia

T2 - Clinical, radiologic, and intraoperative correlates

AU - Tubbs, R. Shane

AU - Mosier, Kristine

AU - Cohen-Gadol, Aaron

PY - 2013/12

Y1 - 2013/12

N2 - Objective: Geniculate neuralgia is an uncommon pain syndrome that can be severe and disabling and is difficult to diagnose. Methods: The literature was reviewed for geniculate neuralgia, including anatomy, presentation, and treatment. A case illustration was presented that demonstrates the novel brainstem functional imaging findings for geniculate neuralgia. A 39-year-old man presented with a history of left "deep" ear pain within his ear canal. He noted occasional pain on the left side of his face around the ear. He had been treated with neuropathic pain medications without relief. His wife described suicidal ideations discussed by her husband because of the intense pain. Results: The patient's neurologic examination was normal, and otolaryngologic consultation revealed no underlying structural disorder. Anatomic imaging revealed a tortuous vertebral artery-posterior inferior cerebellar artery complex with the posterior inferior cerebellar artery loop impinging on the root entry zone of the nervus intermedius-vestibulocochlear nerve complex and just inferior to the root entry zone of the facial nerve and a small anterior inferior cerebellar artery loop interposed between the cranial nerve VII-VIII complex and the hypoglossal and glossopharyngeal nerves. A left-sided retromastoid craniotomy was performed, and the nervus intermedius was transected. An arterial loop in contact with the lower cranial nerves at the level of the brainstem was mobilized with a polytetrafluoroethylene implant. Conclusions: The patient indicated complete relief of his preoperative pain after surgery. He has remained pain-free with intact hearing and balance.

AB - Objective: Geniculate neuralgia is an uncommon pain syndrome that can be severe and disabling and is difficult to diagnose. Methods: The literature was reviewed for geniculate neuralgia, including anatomy, presentation, and treatment. A case illustration was presented that demonstrates the novel brainstem functional imaging findings for geniculate neuralgia. A 39-year-old man presented with a history of left "deep" ear pain within his ear canal. He noted occasional pain on the left side of his face around the ear. He had been treated with neuropathic pain medications without relief. His wife described suicidal ideations discussed by her husband because of the intense pain. Results: The patient's neurologic examination was normal, and otolaryngologic consultation revealed no underlying structural disorder. Anatomic imaging revealed a tortuous vertebral artery-posterior inferior cerebellar artery complex with the posterior inferior cerebellar artery loop impinging on the root entry zone of the nervus intermedius-vestibulocochlear nerve complex and just inferior to the root entry zone of the facial nerve and a small anterior inferior cerebellar artery loop interposed between the cranial nerve VII-VIII complex and the hypoglossal and glossopharyngeal nerves. A left-sided retromastoid craniotomy was performed, and the nervus intermedius was transected. An arterial loop in contact with the lower cranial nerves at the level of the brainstem was mobilized with a polytetrafluoroethylene implant. Conclusions: The patient indicated complete relief of his preoperative pain after surgery. He has remained pain-free with intact hearing and balance.

KW - Geniculate neuralgia

KW - Magnetic resonance imaging

KW - Nervus intermedius

KW - Posterior fossa surgery

UR - http://www.scopus.com/inward/record.url?scp=84889662893&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84889662893&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2012.11.053

DO - 10.1016/j.wneu.2012.11.053

M3 - Article

VL - 80

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

IS - 6

ER -