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​Geniculate Neuralgia

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What is Geniculate Neuralgia?

Geniculate neuralgia is a condition that is caused by a small nerve (the nervus intermedius) being compressed by a blood vessel.

Geniculate neuralgia results in severe, deep ear pain which is usually sharp—often described as an "ice pick in the ear"—but may also be dull and burning. Ear pain can also be accompanied by facial pain.

This pain can be triggered by stimulation of the ear canal, or can follow swallowing or talking.

Doctors will typically prescribe treatment with medication before recommending surgery. If surgery is required, UPMC’s neurosurgeons may recommend Microvascular Decompression. Microvascular decompression is a surgical procedure that relieves abnormal compression of a cranial nerve.

Diagnosing Geniculate Neuralgia

Your physician will perform a physical exam and will ask about your symptoms.

Geniculate neuralgia symptoms

Symptoms may include:

  • An intermittent stabbing pain, like an electric shock, deep in the ear
  • Some people have reported additional symptoms during pain attacks:
    • Salivation
    • Bitter taste
    • Tinnitus
    • Vertigo

Geniculate Neuralgia Treatment

Geniculate neuralgia treatment can be medical or surgical.


Several medications are available to treat geniculate neuralgia, including:

  • Tegretol 
  • Sansert

Surgery: Microvascular Decompression

Surgery to treat geniculate neuralgia is reserved for those patients who are not helped by drug treatments or who experience undesirable side effects from them.

UPMC neurosurgeons typically recommend microvascular decompression and cutting the affected nerve. This procedure has minimal side effects.

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