{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:52:31Z","timestamp":1788288751374,"version":"build-2803163510"},"reference-count":21,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>(1) Background: Painful nervus intermedius neuropathy involves continuous or near-continuous pain affecting the distribution of the intermedius nerve(s). The diagnosis of this entity is challenging, particularly when the clinical and demographic features do not resemble the typical presentation of this condition. To the best of our knowledge, only three case reports have described the occurrence of nervus intermedius neuropathy in young patients. (2) Case Description: A 13-year-old female referred to the orofacial pain clinic with a complaint of pain located deep in the right ear and mastoid area. The pain was described as constant, throbbing and dull, with an intensity of 7\/10 on numerical rating scale, characterized by superimposed brief paroxysms of severe sharp pain. The past treatments included ineffective pharmacological and irreversible surgical approaches. After a comprehensive evaluation, a diagnosis of idiopathic painful nervus intermedius neuropathy was given, which was successfully managed with the use of gabapentin. (3) Conclusions and Practical Implications: The diagnosis and treatment of neuropathic pain affecting the nervus intermedius can be challenging due to the complex nature of the sensory innervation of the ear. The diagnosis can be even more challenging in cases of atypical clinical and demographic presentations, which in turn may result in unsuccessful, unnecessary, and irreversible treatments. Multidisciplinary teams and constant knowledge update are fundamental to provide good quality of care to our patients and not to overlook any relevant signs or symptoms.<\/jats:p>","DOI":"10.3390\/children9081234","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T20:58:08Z","timestamp":1660597088000},"page":"1234","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Rare Case of Idiopathic Painful Nervus Intermedius Neuropathy in a 13-Year-Old Female: A Case Report and Discussion in the Context of the Literature"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0445-6529","authenticated-orcid":false,"given":"Diego","family":"Fernandez-Vial","sequence":"first","affiliation":[{"name":"Department of Oral Health Science, Division of Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1386-5594","authenticated-orcid":false,"given":"Linda","family":"Sangalli","sequence":"additional","affiliation":[{"name":"Department of Oral Health Science, Division of Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Perez","sequence":"additional","affiliation":[{"name":"Department of Oral Health Science, Division of Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1177\/0333102413485658","article-title":"The International Classification of Headache Disorders, 3rd edition (beta version)","volume":"33","author":"Olesen","year":"2013","journal-title":"Cephalalgia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1111\/head.14066","article-title":"A pain in the ear: Two case reports of nervus intermedius neuralgia and narrative review","volume":"61","author":"Robblee","year":"2021","journal-title":"Headache"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1159\/000509760","article-title":"A Case Report of Pediatric Geniculate Neuralgia Treated with Sectioning of the Nervus Intermedius and Microvascular Decompression of Cranial Nerves IX and X","volume":"55","author":"Zenonos","year":"2020","journal-title":"Pediatr. Neurosurg."},{"key":"ref_4","first-page":"22","article-title":"Nervus Intermedius Neuralgia in a Ten-Year-Old Boy","volume":"4","author":"Grin","year":"2020","journal-title":"Int. J. Med. Rev. Case Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"189","DOI":"10.3171\/2020.3.PEDS19584","article-title":"Geniculate neuralgia in an adolescent treated via sectioning of the nervus intermedius and microvascular decompression","volume":"26","author":"George","year":"2020","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1097\/AJP.0000000000000406","article-title":"Psychometric Properties of the Numerical Rating Scale to Assess Self-Reported Pain Intensity in Children and Adolescents: A Systematic Review","volume":"33","author":"Castarlenas","year":"2017","journal-title":"Clin. J. Pain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/0972-2327.107662","article-title":"An uncommonly common: Glossopharyngeal neuralgia","volume":"16","author":"Singh","year":"2013","journal-title":"Ann. Indian Acad. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.wneu.2012.03.023","article-title":"The nervus intermedius: A review of its anatomy, function, pathology, and role in neurosurgery","volume":"79","author":"Tubbs","year":"2013","journal-title":"World Neurosurg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s11916-016-0547-y","article-title":"Red Ear Syndrome","volume":"20","author":"Raieli","year":"2016","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_10","first-page":"99","article-title":"Orofacial pain management: Current perspectives","volume":"7","author":"Uyanik","year":"2014","journal-title":"J. Pain Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"790420","DOI":"10.3389\/fpain.2021.790420","article-title":"Pediatric Chronic Orofacial Pain: A Narrative Review of Biopsychosocial Associations and Treatment Approaches","volume":"2","author":"Sangalli","year":"2021","journal-title":"Front. Pain Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1177\/0333102417704187","article-title":"Mechanisms of craniofacial pain","volume":"37","author":"Chichorro","year":"2017","journal-title":"Cephalalgia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/S1474-4422(20)30233-7","article-title":"Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia","volume":"19","author":"Bendtsen","year":"2020","journal-title":"Lancet Neurol."},{"key":"ref_14","first-page":"Cd007963","article-title":"Oxcarbazepine for neuropathic pain","volume":"12","author":"Zhou","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/00002508-200201000-00004","article-title":"Pharmacotherapy of trigeminal neuralgia","volume":"18","author":"Sindrup","year":"2002","journal-title":"Clin. J. Pain"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1111\/papr.12406","article-title":"Efficacy and Safety of Gabapentin vs. Carbamazepine in the Treatment of Trigeminal Neuralgia: A Meta-Analysis","volume":"16","author":"Yuan","year":"2016","journal-title":"Pain Pract."},{"key":"ref_17","first-page":"Cd007938","article-title":"Gabapentin for chronic neuropathic pain in adults","volume":"6","author":"Wiffen","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1001\/jamainternmed.2019.0086","article-title":"A Clinical Overview of Off-label Use of Gabapentinoid Drugs","volume":"179","author":"Goodman","year":"2019","journal-title":"JAMA Intern. Med."},{"key":"ref_19","first-page":"Cd007938","article-title":"Gabapentin for chronic neuropathic pain and fibromyalgia in adults","volume":"2014","author":"Moore","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"352","DOI":"10.3171\/2018.3.JNS172495","article-title":"Pain-free and pain-controlled survival after sectioning the nervus intermedius in nervus intermedius neuralgia: A single-institution review","volume":"131","author":"Holste","year":"2018","journal-title":"J. Neurosurg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1111\/j.1468-2982.2006.01215.x","article-title":"Secondary intermedius neuralgia-like pain in a young child","volume":"26","author":"Boullosa","year":"2006","journal-title":"Cephalalgia"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/8\/1234\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:09:10Z","timestamp":1760141350000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/8\/1234"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,15]]},"references-count":21,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["children9081234"],"URL":"https:\/\/doi.org\/10.3390\/children9081234","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202208.0165.v1","asserted-by":"object"}]},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,15]]}}}