Geniculate neuralgia may be related to vascular compression of a small nerve known as the nervus intermedius. This small nerve travels between the seventh and eighth cranial nerves (the nerve that moves the muscles of the face and the hearing and balance nerves).

Geniculate neuralgia, which is also known as nervus intermedius neuralgia, results in severe deep ear pain. The pain is usually sharp and described as an "ice pick in the ear". However, it can be also described as a duller burning pain and can be accompanied by facial pain.

Some medications can be effective in treating this such as Tegretol or Sansert. An operation is reserved for those patients who fail medical treatment either because of continued pain or undesirable side effects from the medicines. The operation consists of microvascular decompression and section of the nervus intermedius. Sectioning this small nerve carries minimal side effects.