Aa
geniculate neuralgia
Dear Doctor,
I have occasional stabbing pain in my left ear for past 3 years.
It started with slight numbness,then developed as a pressure and finally stabbing pain on the outer ear(left).
I had consulted a ENT doctor and a Neurosurgeon.ENT was Normal.CT scan Brain Plain and MRI Brain Plain were normal.
Iam getting intermittent pain on my let ear but it becomes alright with some antibiotics subscribed by the ENT.
The neurosurgeon says it as Geniculate neuralgia.
Please advise is it a ENT problem or Neuro problem.
Please also advise what is the treatment for Geniculate Neuralgia.
Regards
I have occasional stabbing pain in my left ear for past 3 years.
It started with slight numbness,then developed as a pressure and finally stabbing pain on the outer ear(left).
I had consulted a ENT doctor and a Neurosurgeon.ENT was Normal.CT scan Brain Plain and MRI Brain Plain were normal.
Iam getting intermittent pain on my let ear but it becomes alright with some antibiotics subscribed by the ENT.
The neurosurgeon says it as Geniculate neuralgia.
Please advise is it a ENT problem or Neuro problem.
Please also advise what is the treatment for Geniculate Neuralgia.
Regards
A long-delayed addition to this thread, if I may. Especially for the doctor contributors: is glycerol rhizotomy an indicated procedure for dealing with geniculate neuralgia? As a (non-physician) network support contact for the Trigeminal Neuralgia Association, I'm talking with a patient who has that diagnosis and whose neurosurgeon claims that glycerol injection should be effective against the disorder even though it was administered under an assumption that she was actually dealing with trigeminal neuralgia. I don't see glycerol indicated among treatments commonly discussed in online sources pertinent to GN.
Any thoughts will be appreciated...
Regards
Hello Dr. Godofredo, I have been diagnosed with GN since May of 2007, I think this is the worst pain anyone could go thru. My question to you is,I also have Multiple sclerosis, diagnosed in 1999 I've been told that I'm not a candidate for MVD due to the failure rate in ms patients, do you know if this is true? I did have thermal rizotomy in Oct of 07 only to have it fail with-in a week.(missed diagnosed for trigeminal neuralgia) I no longer work or drive due to constant pain. Just want my life back. Any help would be appreciated. Thank you, Nelson
plain mri not good enough you need MRI with fiesta protocol done at major acadmeic medical center to have a chance of seeing if bood vesel is possible cause.
also 2 things
1) if you have sensory loss ont he outer ear it is highly suggestive of a neuralgia of some type--does ice feel as cold on the back of your affected ear as on the normal ear
2) dysfunction of the nervus intermedius will result in decreased taste sensation on the front part of that side of the toungue. ear infection wont. check and see if you taste a samll amount of sugar differnetly on one side of the fornt of the toungue vs the other--you will likely need help with this. see a major medical center (university) pain clinic for other conservative measure and diagnosis
also 2 things
1) if you have sensory loss ont he outer ear it is highly suggestive of a neuralgia of some type--does ice feel as cold on the back of your affected ear as on the normal ear
2) dysfunction of the nervus intermedius will result in decreased taste sensation on the front part of that side of the toungue. ear infection wont. check and see if you taste a samll amount of sugar differnetly on one side of the fornt of the toungue vs the other--you will likely need help with this. see a major medical center (university) pain clinic for other conservative measure and diagnosis
Hi.
The diagnosis of geniculate neuralgia warrants normal findings on all tests for causes of otalgia (ear pain) so a normal finding on MRI is consistent with geniculate neuralgia.
Geniculate neuralgia is not associated with phlegm and cannot be treated with antibiotics. If your pain (and phlegm) resolves with intake of antibiotics, geniculate neuralgia is unlikely and your symptoms may be more related to an throat or ear infection. You should talk to your ENT physician about this.
The diagnosis of geniculate neuralgia warrants normal findings on all tests for causes of otalgia (ear pain) so a normal finding on MRI is consistent with geniculate neuralgia.
Geniculate neuralgia is not associated with phlegm and cannot be treated with antibiotics. If your pain (and phlegm) resolves with intake of antibiotics, geniculate neuralgia is unlikely and your symptoms may be more related to an throat or ear infection. You should talk to your ENT physician about this.
Dear Doctors,
My MRI scan was Normal.Is this Geniculate neuralgia can be detected by MRI scan.
Can I go for one more MRI scan?
Will this Geniculate neuralgia can give any other complications other than ear pain and facial paralysis?
I always feel some phlegm in my throat before this pain starts.if i antibiotics for this my pain stops.
Please help.
Regards,
Jahan
My MRI scan was Normal.Is this Geniculate neuralgia can be detected by MRI scan.
Can I go for one more MRI scan?
Will this Geniculate neuralgia can give any other complications other than ear pain and facial paralysis?
I always feel some phlegm in my throat before this pain starts.if i antibiotics for this my pain stops.
Please help.
Regards,
Jahan
Hi Jahan,
How is your pain now?
I think you want to know whether it is infection causing earache or geniculate ganglion causing ear pain.
If you are not having infection repeatedly every time you have earache, then it suggests earache due to geniculate neuralgia. This condition may be related to vascular compression of a small nerve known as the nervus intermedius. It usually results in severe deep ear pain. Methysergide or Carbamazepine can be helpful, but if pain still persist, then operation is indicated which consists of micro vascular decompression and section of the nervus intermedius. Sectioning this small nerve carries minimal side effects.
Bye.
How is your pain now?
I think you want to know whether it is infection causing earache or geniculate ganglion causing ear pain.
If you are not having infection repeatedly every time you have earache, then it suggests earache due to geniculate neuralgia. This condition may be related to vascular compression of a small nerve known as the nervus intermedius. It usually results in severe deep ear pain. Methysergide or Carbamazepine can be helpful, but if pain still persist, then operation is indicated which consists of micro vascular decompression and section of the nervus intermedius. Sectioning this small nerve carries minimal side effects.
Bye.
Hi.
If you are asking what is happens in geniculate neuralgia, it's basically a condition possibly caused by neurovascular compression of a small nerve known as the nervus intermedius. The signals sent along this nerve is altered and interpreted by a structure in the brain, known as the geniculate ganglion, as ear pain.
Geniculate neuralgia may also develop following herpes zoster oticus (Ramsey Hunt syndrome), where cold sores occur on the ear drum or ear. This condition is usually associated with facial paresis (weakness), tinnitus, vertigo and deafness.
Hope this helps.
If you are asking what is happens in geniculate neuralgia, it's basically a condition possibly caused by neurovascular compression of a small nerve known as the nervus intermedius. The signals sent along this nerve is altered and interpreted by a structure in the brain, known as the geniculate ganglion, as ear pain.
Geniculate neuralgia may also develop following herpes zoster oticus (Ramsey Hunt syndrome), where cold sores occur on the ear drum or ear. This condition is usually associated with facial paresis (weakness), tinnitus, vertigo and deafness.
Hope this helps.
Dear Mr Caliber2005,
Let me explain case history briefly.
3 years back i felt some numbness on my left outer ear.I had consulted ENT surgeon.He told me that my ENT is Normal and asked me to go for a CT scan (Brain Plain).CT scan was normal.Then i had consulted a Neurologist.She told me that MRI is the Ultimate diagnosis.MRI (brain Plain) was done and it was Normal.
After a year or so , i had started feeling stabbing pain on my ear.I had decided to consult some other ENT surgeon.He told me that i have little throat infection.He gave me some antibiotics and Diacobal injections. i felt no pain.
When the medication was completed the pain started again.
Finally , the other day i had consulted a Neurosurgeon.He told me that i have Geneculate Neuralgia.He gave me Neurica -M 75 capsules and asked me report after 5 days.
Please explain,what is the route cause of my ear ache.
Regards,
Let me explain case history briefly.
3 years back i felt some numbness on my left outer ear.I had consulted ENT surgeon.He told me that my ENT is Normal and asked me to go for a CT scan (Brain Plain).CT scan was normal.Then i had consulted a Neurologist.She told me that MRI is the Ultimate diagnosis.MRI (brain Plain) was done and it was Normal.
After a year or so , i had started feeling stabbing pain on my ear.I had decided to consult some other ENT surgeon.He told me that i have little throat infection.He gave me some antibiotics and Diacobal injections. i felt no pain.
When the medication was completed the pain started again.
Finally , the other day i had consulted a Neurosurgeon.He told me that i have Geneculate Neuralgia.He gave me Neurica -M 75 capsules and asked me report after 5 days.
Please explain,what is the route cause of my ear ache.
Regards,
Hi.
Once all other causes of otalgia has been ruled out and a diagnosis of geniculate neuralgia has been made, treatment can be started.
Initial treatment is conservative. Carbamazepine and methylsergide has been reported to be effective in treating this condition.
Surgical treatment is only indicated when conservative treatment fails or when side effects of these medications have become severe. The procedure consists of excision of the nervus intermedius and the geniculate ganglion via a middle cranial fossa surgical approach.
If ever surgery is indicated, the decision on whether to consult a neurosurgeon or an ENT surgeon is a gray area. Both specialties have extensive expertise in the area of otoneurology that either one may be consulted.
Hope this helps.
Once all other causes of otalgia has been ruled out and a diagnosis of geniculate neuralgia has been made, treatment can be started.
Initial treatment is conservative. Carbamazepine and methylsergide has been reported to be effective in treating this condition.
Surgical treatment is only indicated when conservative treatment fails or when side effects of these medications have become severe. The procedure consists of excision of the nervus intermedius and the geniculate ganglion via a middle cranial fossa surgical approach.
If ever surgery is indicated, the decision on whether to consult a neurosurgeon or an ENT surgeon is a gray area. Both specialties have extensive expertise in the area of otoneurology that either one may be consulted.
Hope this helps.
Hi jahan,
How are you feeling now?
I think before a diagnosis of geniculate neuralgia can be made we have to rule out all other causes of pain in ear.
ENT surgeon should perform a clinical examination and do an audiogram, BAER and possibly caloric testing. Were all this being done for you, if yes what were the results? As you have told every time you have pain, ENT surgeon after examination, gives antibiotics which corrects your pain, suggest infective pathology.
If pain due to infective pathology is persistent, it suggests a source of infection being persistent.
A thorough clinical examination by another ENT surgeon will help in coming to a conclusion.
As your MRI and CT scan are normal goes in favor in ruling out other causes of ear pain.
Finally, examinations of the nose, paranasal sinuses, mouth, teeth, nasopharynx, pharynx, and larynx must reveal no cause for the pain.
Definitive treatment for geniculate neuralgia is surgery involving excision of ganglion.
But prior to this I suggest you to see another ENT surgeon (person who does not know the first ENT surgeon) and review your case.
How are you feeling now?
I think before a diagnosis of geniculate neuralgia can be made we have to rule out all other causes of pain in ear.
ENT surgeon should perform a clinical examination and do an audiogram, BAER and possibly caloric testing. Were all this being done for you, if yes what were the results? As you have told every time you have pain, ENT surgeon after examination, gives antibiotics which corrects your pain, suggest infective pathology.
If pain due to infective pathology is persistent, it suggests a source of infection being persistent.
A thorough clinical examination by another ENT surgeon will help in coming to a conclusion.
As your MRI and CT scan are normal goes in favor in ruling out other causes of ear pain.
Finally, examinations of the nose, paranasal sinuses, mouth, teeth, nasopharynx, pharynx, and larynx must reveal no cause for the pain.
Definitive treatment for geniculate neuralgia is surgery involving excision of ganglion.
But prior to this I suggest you to see another ENT surgeon (person who does not know the first ENT surgeon) and review your case.
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