? sectioning of nervus intermedius?


Does anybody know why Dr Michael Horowitz in Pittsburg, PA sections the nervus intermedius on many MVDs?

I heard this many times by now?

I am asking because within the next 2 month I will have my second MVD of 9th and 10th cranial nerve.

My first MVD was a big failure. The teflon sponge inserted in August 2014 causes a lot of trouble and needs to be removed again.

First surgery was done in Germany and now back home in Austria.




I'm scheduled for a consult then surgery with Horowitz in two weeks. My understanding is the nervus intermedius is a non - essential part of the Facial Nerve structure - (CN VII I think) . So, I think it is done when they suspect geniculate neuralgia only.It relieves ear pain and other stuff. If you have GPN only , they don't do it. There is a white paper on the procedure that suggests that it is an effective, safe part of the surgery. Google Microvascular Decompression for Geniculate Neuralgia - or it may be GPN and GN.

Good luck (I'm nervous) ,,


Hi Eddie

Thanks for the Info, I will research it and ask my surgeon about it because I have GPN, ear pain, all the left side of my head ....

Don`t worrie about the surgerie too much. For some people it realy is a non event and they are pain free afterwards ....

all the best



Sounds good.

Check out Geniculate Neuralgia for the classic symptoms




I am curious. Why have you chosen an MVD over the rhizotomy?


I did not wish to have a MVD, I always wanted to have a rhizotomy straight away …

Last I was under a lot of pressure of losing my job and rhizotomies are in general not performed in Europe.

My Allianz Insurance refused to pay for the rhizotomy in the USA, so I chose the best option available and had a MVD in Germany in August 2014.

The MVD was totally fu…ed up and made things a lot worse.

Within the next few weeks I will have a surgery at home in Austria to hopefully fix the problem. My neurosurgeon will take out the Teflon sponge and will decide what to do during the surgery once he sees what’s actually happening in there.

I hope he performs the rhizotomy of 9th and (partial) 10th cranial nerve and that I get my life back.

MVDs are actually not that effective, especially not for atypical GPN.

Well now you know

Get well


Thanks so much for the response Mike. Mine is a mix of atypical and typical. So I take it yours is atypical? I was not sure if they did surgery for that. I have constant pain and also the sharp shooting pains. The sharp shooting pains mostly go away with the gabapentin. I still have weakness on the right side of my mouth and tongue though. I wish I knew someone else that had that. It has been going on for over 15 years. the constant pain just started last feb.

I hope very much that you get your life back. I had to let my job go 15 years ago and have never been able to leave far from my town for the last 15 years in case I start to have an attack. I had to move near my family and lost two marriages- I have no desire to try that anymore but I would like to have more freedom. I have to get to a dark place and take meds to prevent vertigo. From reading what I have I think the vertigo may be a vagus problem. My balance nerve was killed off and that helped but I still get the faint feeling. My blood pressure is very low and although I have not fainted in 15 years I used to. My heart would race then I would get lightheaded and have to sit or lay down before I fainted. I hope you have not experienced vertigo- it is something that I could have never imagined.

My problems have been going on for 15 years and I have never really gotten a good explanation and I have been to the best hospitals around. I went to Hopkins 27 years ago and they diagnosed with meneire then 15 years ago University MD diagnosed me with with basilar artery migraine and just recently with GPN. It is all on the right side. I cannot tell you how many docs have told me they are all unrelated and of course that is BS. I think now all of this has to do with messed up cranial nerves.

All the best and hope you let us know how your surgery goes.

Hi Peacefulbuttons

I can totally understand you. Also lost my job, wife etc. ...

You are right I do have the atypical GPN and that made things that complicated, because most doctors don`t even know about it.

Your case seems to be as messed up as mine, too many problems at once and it is hard to find someone who sees the big picture and has the knowlege and guts to treat a patient like this. I am glad that I finally found an amazing neurosurgeon who might be able to get me fixed again .. I don`t think that I will ever be painfree again but I am hoping for a lot more quality of life.

He works in Austria but if you want to give it a trie, he is worth it. Best and most qualified Doc I have met in my 7 years of pain.

All the best


Hi Mike,
He sections the nervous intermedious if you have Geniculate Neuralgia. I had both GPN and GN. The nervous intermedious is what causes you to feel the stabbing ice pick in the ear pain. When the nerve is cut the hope is that you won’t feel the pain anymore.
My surgery was 100% effective. I wouldn’t have cared if he had to sever more nerves as long as the pain would be gone. Besides the nervous intermedious thing I had MVD of the 5th, 9th, and 10th cranial nerve.

Did you have any lasting side effects from the surgery? From sectioning the nervus intermedius? We are possibly looking at this surgery for our 12 yr old who has been suffering with GN for 2 1/2 years and would love to hear from anyone with experience with that surgery. :slight_smile: Also,who did your surgery?
Thank you in advance!

Just checking back. I wish Laura would see this and reply. Or anyone else who's have the nervus intermedius sectioned and any ongoing results? We are now almost 3 1/2 years into this uncontrolable pain for our daughter. Anyone's input would be FANTASTIC! Thanks for sharing any experience!

Andie, why don't you send Laura a 'friend' request and see if she answers. Go to your user name box at the top right of your screen and select Friends Invite or go to Laura page and do it from there. JulesG