Glossopharyngeal Neuralgia

Key Features

• An uncommon disorder with throat pain similar in quality to that in trigeminal neuralgia

Clinical Findings

• Pain occurs in the throat, about the tonsillar fossa, and sometimes deep in the ear and at the back of the tongue

• The pain may be precipitated by swallowing, chewing, talking, or yawning and is sometimes accompanied by syncope

Diagnosis

• In most instances, no underlying structural abnormality is present

• Microvascular compression of glossopharyngeal nerve may be underlying pathogenesis

• Multiple sclerosis or other brainstem lesions are sometimes responsible

Treatment

• Oxcarbazepine or carbamazepine is the treatment of choice and should be tried before any surgical procedures are considered

• Microvascular decompression is often effective and is generally preferred over destructive surgical procedures such as partial rhizotomy in medically refractory cases