Intermedius nerve neuralgia is a rare disorder involving a branch of the facial nerve, causing brief paroxysms of pain unilaterally in the auditory canal, which can radiate to the parieto-occipital region. It may be idiopathic in origin or secondary to herpes zoster1. It can be confused with glossopharyngeal neuralgia with a primarily otitic component, which may be differentiated with surgical exploration1. Microvascular decompression (MVD) is recommended as first-line management1.


  1. Tubbs RS, Steck DT, Mortazavi MM, Cohen-Gadol AA. (2013). The Nervus Intermedius: A Review of Its Anatomy, Function, Pathology, and Role in Neurosurgery. World Neurosurgery. 79(5-6): 763-767.