What are the other Names for this Condition? (Also known as/Synonyms)

• Painful Nervus Intermedius Neuralgia Attributed to Shingles
• Painful Nervus Intermedius Neuralgia due to Herpes Zoster
• Painful Nervus Intermedius Neuralgia due to Shingles

What is Painful Nervus Intermedius Neuralgia Attributed to Herpes Zoster? (Definition/Background Information)

• The nervus intermedius forms a part of the facial nerve (cranial nerve 7). Painful nervus intermedius neuralgia may be described as continuous to near-continuous pain, typically felt on one side of the face (near the ear), from involvement of the nerve branches
• The variable intensity pain appears as a shooting or burning pain that may be triggered by external stimulus such as touching, noise, or cold temperatures. Brief episodes of severe pain is not a common occurrence in painful nervus intermedius neuralgia
• Painful Nervus Intermedius Neuralgia Attributed to Herpes Zoster is a pain disorder that occurs secondary to acute herpes zoster. Herpes zoster, or shingles, is a viral infection caused by the reactivation of the varicella-zoster virus (VZV). This skin condition is exclusively described in individuals who had a past history of chickenpox; also, immunocompromised individuals have a higher risk for the same. The infection affects the nervous system causing the formation of tiny red blisters on the body, among other symptoms
• The pain in painful nervus intermedius neuralgia may appear before the herpetic skin eruptions are noted. The involvement of other cranial nerves may take place due to the viral infection, causing ringing in the ears, balance issues, swallowing difficulties, hoarse voice, and hearing impairment, among other symptoms
• When facial muscle weakness and paralysis is observed in Painful Nervus Intermedius Neuralgia Attributed to Herpes Zoster, the condition is known as Ramsay Hunt syndrome

The criteria for diagnosis of Painful Nervus Intermedius Neuralgia Attributed to Herpes Zoster as outlined by the International Headache Society (IHS) is given below:

• One or more of the following:
  • Herpetic eruption has occurred in the distribution of nervus intermedius
  • Varicella zoster virus (VZV) has been detected in the CSF by polymerase chain reaction (PCR)
  • Direct immunofluorescence assay for VZV antigen or PCR assay for VZV DNA is positive in cells obtained from the base of lesions
• Unilateral continuous or near-continuous pain in the distribution of nervus intermedius and fulfilling the criterion below
• Pain developed in temporal relation to the herpes zoster
• Not better accounted for by another ICHD-3 diagnosis

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)