Idiopathic NIN (aka geniculate neuralgia) is a rare cranial neuralgia that presents as severe paroxysmal pain in the ear canal and auricle. Treatment options are limited.

NIN is a painful cranial neuralgia that is challenging to treat. Due to its rarity, there is inconclusive evidence for treatment guidelines. Current treatment includes carbamazepine, gabapentin, baclofen or neurosurgical procedures if medication fails. There is a paucity of reported cases demonstrating successful response to peripheral nerve blocks in NIN, and two reported cases that report unsuccessful response to block nerve block. We describe our technique for fluoroscopy guided nervus intermedius (geniculate nerve) block for the treatment of NIN and highlights this interventional approach as a treatment option which can be utilized by neurologists or pain physicians for this debilitating condition in which current treatment is limited.