Neuralgia refers to a severe sharp pain, which occurs along the course of a nerve. The XIIth cranial nerve is one of twelve pairs of nerves connected with the brain. It is the motor nerve to the tongue supplying the ipsilateral muscles, which provide tongue movement.

The cause of neuralgia may be unknown, However, identified causes may include: injury or irritation to the nerve; nerve root compression by a blood vessel or tumor; viral infections; chronic degenerative diseases such as multiple sclerosis; toxins; and infections.

Signs and symptoms may occur at irregular intervals with attacks characterized by unilateral, sharp, stabbing, or constant burning pain. Manifestations may include: muscle atrophy; weakness; paralysis; lack of reflexes; deviation of the tongue; fasciculation; dysarthria; and difficulty eating.

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

Treatment may be directed to the specific underlying cause and symptoms, and may include surgery and medications to treat underlying diseases or infection. Nutritional intervention, and physical and speech therapies may be parts of the treatment plan. Other treatments for symptoms of affected neighboring nerves may be indicated.

Regeneration of the nerve may depend on the degree and site of injury. The closer the injury is to the central nervous system (CNS), regeneration of a severely damaged nerve is less likely to occur. Injury to neighboring nerves may also be present. Frequency of attacks may vary with periods of long remissions. However, remission periods may decrease with age. Continuous bouts may be incapacitating, and may alter activities of daily living (ADL). Muscle atrophy and fasciculation may develop weeks to months following nerve injury. Other possible residuals include: a decline in the nutritional status; a need for long-term pain management; medications that may warrant ongoing liver and blood studies; and the potential for paralysis of the nerve.

• 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].

• None.