Neuritis refers to an inflammation of a nerve with pain and tenderness, anesthesia and paresthesia, paralysis, wasting, and disappearance of the reflexes. The Xth cranial nerve is one of twelve pairs of nerves connected with the brain which provides sensation to the ear, tongue, pharynx and larynx, and moves muscles of speech and swallowing. It also sends impulses to the heart, lungs, esophagus, stomach, and smooth muscles of visceral organs.

In some cases, the cause may be unknown. Identified causes may 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 possible 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.

Symptoms may vary depending on the form of neuritis and the location of the lesion along the nerve. Manifestations may include: dysphagia; hoarseness; dyspnea; alteration in the heart rate; sensory loss in the external ear; 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; electromyography (EMG); electrocardiogram (EKG); computed tomography (CT) scan; and magnetic resonance imaging (MRI).

Treatment measures may include: management of the underlying disorder; medications for pain; anti-inflammatory drugs; antibiotics; vitamin therapy; and physical therapy. Nutritional intervention may also be needed. 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. The potential for paralysis of the nerve exists.

• 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 extent of sensory and motor loss to organs of voice, respiration, pharynx, stomach and heart.

• 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)