{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:56:14Z","timestamp":1792515374454,"version":"4.5.0"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8]]},"abstract":"OBJECTIVE<\/jats:title>Geniculate neuralgia (GN) is an uncommon craniofacial pain syndrome attributable to nervus intermedius (NI) dysfunction. Diagnosis and treatment can be challenging, due to the complex nature of ear sensory innervation, resulting in clinical overlap with trigeminal neuralgia (TN) and glossopharyngeal neuralgia (GPN).<\/jats:p><\/jats:sec>METHODS<\/jats:title>A retrospective review of a prospective neurosurgical database at our institution was performed, 2000\u20132017, with a corresponding systematic literature review. Pain outcomes were dichotomized as unfavorable<\/jats:italic> for unchanged\/worsened symptoms versus favorable<\/jats:italic> if improved\/resolved. Eight formalin-fixed brains were examined to describe NI at the brainstem.<\/jats:p><\/jats:sec>RESULTS<\/jats:title>Eleven patients were surgically treated for GN\u20149 primary, 2 reoperations. The median age was 48, 7 patients were female, and the median follow-up was 11 months (range 3\u2013143). Seven had \u2265 2 probable cranial neuralgias. NI was sectioned in 9 and treated via microvascular decompression (MVD) in 2. Five patients underwent simultaneous treatment for TN (4 MVD; 1 rhizotomy) and 5 for GPN (3 MVD; 2 rhizotomy). Eleven reported symptomatic improvement (100%); 8 initially reported complete resolution (73%). Pain outcomes at last contact were favorable<\/jats:italic> in 8 (73%)\u2014all among the 9 primary operations (89% vs 0%, p = 0.054). Six prior series reported outcomes in 111 patients.<\/jats:p><\/jats:sec>CONCLUSIONS<\/jats:title>GN is rare, and diagnosis is confounded by symptomatic overlap with TN\/GPN. Directed treatment of all possible neuralgias improved pain control in almost all primary operations. Repeat surgery seems a risk factor for an unfavorable outcome. NI is adherent to superomedial VIII at the brainstem; the intermediate\/cisternal portion is optimal for visualization and sectioning.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.3.jns172920","type":"journal-article","created":{"date-parts":[[2018,8,10]],"date-time":"2018-08-10T13:59:46Z","timestamp":1533909586000},"page":"343-351","source":"Crossref","is-referenced-by-count":21,"title":["Nervus intermedius and the surgical management of geniculate neuralgia"],"prefix":"10.3171","volume":"131","author":[{"given":"Maria","family":"Peris-Celda","sequence":"first","affiliation":[{"name":"Departments of Neurologic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soliman","family":"Oushy","sequence":"additional","affiliation":[{"name":"Departments of Neurologic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avital","family":"Perry","sequence":"additional","affiliation":[{"name":"Departments of Neurologic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S.","family":"Graffeo","sequence":"additional","affiliation":[{"name":"Departments of Neurologic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas P.","family":"Carlstrom","sequence":"additional","affiliation":[{"name":"Departments of Neurologic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard S.","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Scottsdale, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredric B.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Departments of Neurologic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce E.","family":"Pollock","sequence":"additional","affiliation":[{"name":"Departments of Neurologic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Departments of Neurologic Surgery and"},{"name":"Otolaryngology\u2013Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1016\/S0194-5998(99)70193-2","article-title":"Endoscopy during neurotomy of the nervus intermedius for geniculate neuralgia","volume":"121","author":"Alcaraz N","year":"1999","unstructured":"Alcaraz N, King WA, Wackym PA: Endoscopy during neurotomy of the nervus intermedius for geniculate neuralgia. 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