Neuritis refers to an inflammation of a nerve with pain and tenderness, anesthesia and paresthesia, paralysis, wasting, and disappearing of the reflexes. The IXth cranial nerve is one of twelve pairs of nerves connected with the brain which provides sensory input from the pharynx, tonsils, posterior third of the tongue, and carotid arteries. It also moves the swallowing and salivary gland muscles.

In some cases, the cause may be unknown. Identified causes of the condition include: trauma; tumors; hemorrhage into a nerve; lesions; continuous pressure on a nerve; exposure to cold or radiation; viruses; or infectious disease such as Lyme disease. Other causes include: systemic malignancy; leprosy; metabolic diseases such as diabetes mellitus; collagen blood disorders; toxic agents; certain medications; nutritional deficiencies; metabolic disorders such as alcoholism; and genetics.

Manifestations may vary in terms of the form of neuritis and the location of the lesion along the nerve. These signs and symptoms may include: neuralgia; hyperesthesia; paresthesia; dysesthesia; hypesthesia; anesthesia; muscular atrophy; paralysis; and lack of reflexes.

Diagnostic measures may include: a complete history; physical and neurological examinations; sensory and motor tests; blood studies; spinal tap; computed tomography (CT) scan; and magnetic resonance imaging (MRI).

Treatment may include management of the underlying disorder. Other treatment measures inlcude: medications for pain; anti-inflammatory drugs; antibiotics; vitamin therapy; and physical therapy. Nutritional intervention may be needed and other treatments for symptoms of affected neighboring nerves may be indicated.

There may be an alteration in activities of daily living (ADL). The nutritional status may decline, and there may be a need for long-term pain management. Blood pressure may need on-going monitoring.

• This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a). [chronic disease].

Notes

• Dependent upon relative loss of innervation of facial muscles.

• Disability from lesions of peripheral portions of first, second, third, fourth, sixth, and eighth nerves will be rated under the Organs of Special Sense. The ratings for the cranial nerves are for unilateral involvement; when bilateral, combine but without the bilateral factor.

• Neuritis, cranial or peripheral, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated on the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete, paralysis. See nerve involved for diagnostic code number and rating. The maximum rating which may be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate, or with sciatic nerve involvement, for moderately severe, incomplete paralysis. (38 CFR 4.123)