Neuralgia refers to severe sharp pain occurring along the course of a nerve. The VIIth cranial nerve is one of twelve pairs of nerves connected with the brain, which moves facial expression muscles, provides sensory input for taste in the anterior two-thirds of the tongue, and innervates the tear and salivary glands.

Although, in general, the cause of neuralgia may be unknown, attributing causes may include injury or irritation to the nerve; nerve root compression by a blood vessel or tumor; viral infections; multiple sclerosis; and toxins.

Signs and symptoms are similar to those of trigeminal neuralgia (see Diagnostic Code: 8405 Fifth [trigeminal] cranial nerve-Neuralgia), and may be characterized by attacks of excruciating, sharp, stabbing pain, or constant burning pain in the lips, gums, cheek, chin or forehead. Symptoms may occur at irregular intervals. There may be hypersensitivity to touch, which may provoke new attacks.

Diagnostic measures may include: physical and neurological examinations; sensory and motor tests; and electromyography (EMG).

Anticonvulsant medication may be given. Peripheral nerve blocks may be done if pain medication fails. In some cases, surgery may be done when medical therapy fails.

The frequency of attacks may vary, with periods of long remissions. Continuous bouts may be incapacitating. In the event of surgery, there may be paralysis of one-half of the tongue. Hemifacial spasms may develop in the future. The nutritional status may decline during periods of attacks, and medications may warrant on-going liver and blood studies.

• 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].

• Dependent upon loss of motor function of tongue.