Skip to main content
Woman talking with her doctor.

Compassionate Care for Geniculate Neuralgia

Expert Geniculate Neuralgia Care

There are billions of nerve cells in the human body. They allow us to smile, cry, dream and taste — and so much more. But when a nerve is damaged or pinched, your body will let you know. Nerve pain, also called neuralgia, can be severe and debilitating. 

If your life is affected by nerve pain like geniculate neuralgia, we’re here to help. Our multidisciplinary neurovascular specialists have extensive experience diagnosing and treating both common and complex cranial nerve syndromes. Getting the right diagnosis is an essential first step toward relieving your symptoms. 

With a range of treatment options for geniculate neuralgia, including microvascular decompression surgery, we’re here to help you see past your nerve pain. Because your future is bright and we want to empower you to feel assured in body, mind and spirit.

About Geniculate Neuralgia

Geniculate neuralgia is a rare type of nerve pain that happens when a branch of the facial nerve called the nervus intermedius becomes damaged or compressed. Ear pain, ranging from mild to debilitating, is one of the most common symptoms of this syndrome. 

An enlarged or abnormal blood vessel is usually the source of the compression. Because the facial nerve is an intracranial nerve (located inside the skull), it can be difficult or impossible to access. 

Treatment for geniculate neuralgia usually involves managing symptoms with medication and noninvasive therapies. In severe cases, surgery may be recommended to decompress the facial nerve. 

Debilitating ear pain is the most common symptom of this neurovascular syndrome. Some people have described the pain as a stabbing sensation deep within the ear, or as a feeling like an electric shock. The pain usually comes and goes and may be triggered by things like cold wind or loud music. Symptoms almost always affect only one ear. 

Additional forms of geniculate neuralgia ear pain can include:

  • A burning sensation around one ear
  • Dizziness
  • Loss of balance
  • Ringing in one ear (tinnitus)

Vascular abnormalities are the leading cause of facial nerve pain. Enlarged or irregularly shaped vessels can pinch the nerve and trigger intense pain signals. Some of the most common conditions of the head, neck and brain that can lead to intracranial nerve compression include:

  • Aneurysm
  • Arteriovenous fistula (AVF) 
  • Arteriovenous malformation (AVM) 
  • Brain lesions
  • Brain tumors

It can be difficult to diagnose geniculate neuralgia. Ear pain and face pain can have so many different causes that most doctors may not test for this rare disorder. Many people see an otolaryngologist for their symptoms, not a neurovascular specialist. The condition is sometimes misdiagnosed as an ear infection, a ruptured eardrum or a migraine headache.

If you are experiencing chronic episodes of severe neuralgia in the ear or face, it might be time to see a neurologist or neurovascular specialist. This type of doctor has experience diagnosing and treating nerve syndromes caused by blood vessel disorders. 

Tests can help determine if geniculate neuralgia or another craniofacial pain syndrome like trigeminal neuralgia or glossopharyngeal neuralgia is causing your symptoms. 

Due to its location inside the skull, the facial nerve and its branches can be difficult to reach. Medication will likely be the first line of defense against your nerve pain. The most common medications for geniculate neuralgia are carbamazepine (an anticonvulsant) and methysergide maleate (used to treat migraines and cluster headaches). 

Geniculate Neuralgia Surgery: Microvascular Decompression

Surgery for geniculate neuralgia is usually a last-resort treatment option for pain that hasn’t responded to medication or other noninvasive therapies. 

Your doctor may recommend a procedure called microvascular decompression. This is a minimally invasive surgery aimed at relieving pressure on the intermedius nerve by placing a tiny, sponge-like pad between the nerve and the abnormal blood vessel. 

At the AdventHealth Neuroscience Institute, we offer endoscopic and microscopic microvascular decompression for: 

  • Geniculate neuralgia
  • Trigeminal neuralgia
  • Other craniofacial pain syndromes

This innovative surgical technique allows us to access nerves inside the skull with fewer risks and less downtime for you. 

Doctor talking with a patient.

We Make Health Care Easy, You Make It Special

Getting the treatment you need shouldn’t be confusing or stressful. Expert health care shouldn’t be intimidating. When you choose the AdventHealth Neuroscience Institute for your neurovascular care, we’ll guide you through every step of the treatment process with compassion and patience. 

Meet Your Care Coordinator