Nervus Intermedius Neuralgia With Vestibular Paroxysmia -A Rare Combination of Nerve Compression Syndromes

Abstract

Introduction: Posterior cranial fossa nerve compressions in a rare combination are discussed here.
Case Reports: 51 year old male with intractable vertigo, vomiting and left ear ache, had left spontaneous nystagmus. Another 25 year old female had recurrent ear ache and vertigo. Both MRI Brain showed compression of VII/VIII nerve complex in the cistern. They were given Ox carbamazepine with supportive therapy tapered with no recurrence in past 1 year.
Discussion: The combination of the 7th and 8th cranial neuralgias presents with common symptomatology. The investigation of choice is HR T2 weighted MRI brain (CISS/FIESTA SPACE sequence), treated medically. Surgically, decompression or nerve sectioning are done.
Conclusion: Though rare due to different positions of the nerve entry/exit zones of these nerves, this combination of posterior cranial fossa nerve compression syndromes can coexist. Diagnosis can help in the proper management of such patients and even open the horizon for surgical options in recalcitrant cases.