{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:25:17Z","timestamp":1787034317923,"version":"build-2736575974"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nervus intermedius neuralgia (NIN) is a rare craniofacial pain syndrome. Bilateral involvement is extremely uncommon, and the pathophysiology and precipitating factors of NIN remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 57-year-old female presented with a 3-month history of bilateral paroxysmal stabbing deep ear pain triggered by cold wind and auricular pressure, superimposed on a persistent dull ache. She had a 5-year history of hypertension, with poor blood pressure control (140\u2013160\/90\u2013105\u2005mmHg) for four months preceding symptom onset. Otoscopic examination revealed bilateral external auditory canal eczema. Dedicated cranial MRI demonstrated bilateral anterior inferior cerebellar artery (AICA) loops in contact with the facial-vestibulocochlear nerve complexes, with no vascular contact at the trigeminal or glossopharyngeal nerves. A clinical diagnosis of bilateral NIN was established according to ICHD-3 criteria. The patient responded favorably to pregabalin combined with strict blood pressure control. At three-month follow-up, her stabbing pain had essentially resolved (VAS: 0\u20131\/10).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This first case of bilateral NIN with radiologically confirmed bilateral neurovascular contact supports neurovascular conflict as a pathophysiological mechanism even in bilateral presentations. Uncontrolled hypertension and local inflammation may serve as potential precipitating factors. A conservative approach combining pharmacotherapy with cardiovascular risk factor management may achieve favorable outcomes, potentially avoiding surgery in selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpain.2026.1862625","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:36:51Z","timestamp":1787031411000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral nervus intermedius neuralgia with neurovascular contact: a case report highlighting hypertension and eczema as potential precipitating factors"],"prefix":"10.3389","volume":"7","author":[{"given":"Shusheng","family":"Jiao","sequence":"first","affiliation":[{"name":"Department of Neurology, Bethune International Peace Hospital","place":["Shijiazhuang, Hebei, 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