Neuralgia of the intermediate nerve due to vertebrobasilar dolichoectasia

Authors

Keywords:

NEURALGIA, HEADACHE.

Abstract

Introduction: the intermediate nerve constitutes the sensory root of the facial nerve and was described by Wrisberg in 1777 as a separate branch. Among its functions are the control of salivary and lachrymal secretion, gustatory function and cutaneous sensitivity of parts of the external ear. Vertebrobasilar dolichoectasia is characterized by a dilated, elongated and tortuous vertebrobasilar complex.

Case report: patient with headache of two months of evolution, referred to the region of the auricle and left external auditory canal, of sudden onset, duration of less than one minute, of electrical character and severe intensity according to visual analog scale. Neuralgia of the left intermediate nerve was suspected. A multi-slice tomography of the cranium-encephalon and magnetic resonance of the cranium-encephalon with angiography technique were performed. There was no evidence of intracranial space occupying lesion or in the auditory canal. There was evidence of elongated and distended vertebrobasilar complex, diagnosing vertebrobasilar dolichoectasia. Treatment with carbamazepine 600mg daily was started, resulting in total resolution of the painful crises.

Conclusions: neuralgia of the intermediate nerve should be considered as differential diagnosis in patients with neuropathic pain referred to the external auditory canal region. Vertebrobasilar dolichoectasia was identified as the cause of neural compression. Pharmacological treatment constitutes the first line of treatment for these patients.

 

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Author Biographies

Raúl González Pimentel, Universidad de Ciencias Médicas de Pinar del Río. Hospital General Docente "Abel Santamaría Cuadrado"

Especialista de primer grado en Neurocirugía. Hospital General Docente "Abel Santamaría Cuadrado"

Yaneisis García Molina, Universidad de Ciencias Médicas de Pinar del Río. Hospital General Docente "Abel Santamaría Cuadrado"

Especialista de primer grado en Estomatología General Integral. Hospital General Docente "Abel Santamaría Cuadrado"

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Published

2022-02-28

How to Cite

1.
González Pimentel R, García Molina Y. Neuralgia of the intermediate nerve due to vertebrobasilar dolichoectasia. Rev Ciencias Médicas [Internet]. 2022 Feb. 28 [cited 2025 Aug. 4];26(2):e5272. Available from: https://revcmpinar.sld.cu/index.php/publicaciones/article/view/5272

Issue

Vol. 26 No. 2 (2022)

Section

CASE REPORTS

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