title: The nervus intermedius: a review of its anatomy, function, pathology, and role in neurosurgery.
abstract: BACKGROUND
  Geniculate neuralgia, although uncommon, can be a debilitating pathology. Unfortunately, a thorough review of this pain syndrome and the clinical anatomy, function, and pathology of its most commonly associated nerve, the nervus intermedius, is lacking in the literature. Therefore, the present study aimed to further elucidate the diagnosis of this pain syndrome and its surgical treatment based on a review of the literature.
  
  
  METHODS
  Using standard search engines, the literature was evaluated for germane reports regarding the nervus intermedius and associated pathology. A summary of this body of literature is presented.
  
  
  RESULTS
  Since 1968, only approximately 50 peer-reviewed reports have been published regarding the nervus intermedius. Most of these are single-case reports and in reference to geniculate neuralgia. No report was a review of the literature.
  
  
  CONCLUSIONS
  Neuralgia involving the nervus intermedius is uncommon, but when present, can be life altering. Microvascular decompression may be effective as a treatment. Along its cisternal course, the nerve may be difficult to distinguish from the facial nerve. Based on case reports and small series, long-term pain control can be seen after nerve sectioning or microvascular decompression, but no prospective studies exist. Such studies are now necessary to shed light on the efficacy of surgical treatment of nervus intermedius neuralgia.
authors.affiliation: Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama, USA.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Dominik T
authors.initials: DT
authors.lastname: Steck
authors.forename: Martin M
authors.initials: MM
authors.lastname: Mortazavi
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Cohen-Gadol
mesh_terms: D003390:Cranial Nerve Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D004424:Ear Canal / Q000294:innervation; D004433:Earache / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005154:Facial Nerve / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D005155:Facial Nerve Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005157:Facial Pain / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016697:Herpes Zoster Oticus / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007765:Lacrimal Apparatus / Q000294:innervation; D061145:Microvascular Decompression Surgery / Q000379:methods; D009666:Nose / Q000294:innervation; D010159:Palate / Q000294:innervation; D017777:Parasympathetic Fibers, Postganglionic / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D012867:Skin / Q000294:innervation; D014059:Tongue / Q000294:innervation