Glossopharyngeal neuralgia is a condition in which there are repeated episodes of severe pain in the tongue, throat, ear, and tonsils, which can last from a few seconds to a few minutes.
Alternative NamesCranial mononeuropathy IX
Causes, incidence, and risk factorsGlossopharyngeal neuralgia is believed to be caused by irritation of the ninth cranial nerve. Symptoms usually begin in people over age 40.
In most cases, the source of irritation is never found. Some possible causes for this type of nerve pain (neuralgia) are:
Symptoms include severe pain in areas connected to the ninth cranial nerve:
The pain occurs in episodes and may be severe. It can sometimes be triggered by:
Tests will be done to identify problems, such as tumors, at the base of the skull. Tests may include:
Sometimes the MRI may show swelling (inflammation) of the glossopharyngeal nerve.
To find out whether a blood vessel is pressing on the nerve, pictures of the brain arteries may be taken using:
Certain blood tests may be needed when the diagnosis is not clear to rule out other causes of peripheral nerve problems (neuropathy), such as high blood sugar.
TreatmentThe goal of treatment is to control pain. Over-the-counter pain killers such as aspirin and acetaminophen (Tylenol) are not very effective for the relief of neuralgia.
The most effective drugs are antiseizure medications, such as carbamazepine, gabapentin, and phenytoin. Some antidepressants, such as amitriptyline, may help certain people.
In severe cases, when pain is difficult to treat, surgery to take pressure off the glossopharyngeal nerve may be needed. This surgery is generally considered effective. If a cause of the neuralgia is found, treatment should control the underlying problem.
Expectations (prognosis)How well you do depends on the cause of the problem and the effectiveness of the first treatment. Surgery is considered effective for people who do not benefit from medications.
ComplicationsSlow pulse and fainting may occur when pain is severe.
Medications used to treat this condition can have side effects.
Calling your health care providerCall your health care provider if you have symptoms of glossopharyngeal neuralgia. See a pain specialist if the pain is severe to be sure that you are aware of all your options for controlling pain.
Glossopharyngeal neuralgia is a condition in which there are repeated episodes of severe pain in the tongue, throat, ear, and tonsils, which can last from a few seconds to a few minutes.
Alternative NamesCranial mononeuropathy IX
Causes, incidence, and risk factorsGlossopharyngeal neuralgia is believed to be caused by irritation of the ninth cranial nerve, called the glossopharyngeal nerve. Symptoms usually begin in people over age 40.
In most cases, the source of irritation is never found. Some possible causes for this type of nerve pain (neuralgia) are:
Symptoms include severe pain in areas connected to the ninth cranial nerve:
The pain occurs in episodes and may be severe. It is usually on one side, and feels jabbing. The episodes can occur many times each day, and awaken the person from sleep.
It can sometimes be triggered by:
Tests will be done to identify problems, such as tumors, at the base of the skull. Tests may include:
Sometimes the MRI may show swelling (inflammation) of the glossopharyngeal nerve.
To find out whether a blood vessel is pressing on the nerve, pictures of the brain arteries may be taken using:
The goal of treatment is to control pain. Over-the-counter painkillers such as aspirin and acetaminophen (Tylenol) are not very effective for relieving glossopharyngeal neuralgia.
The most effective drugs are antiseizure medications, such as carbamazepine, gabapentin, and phenytoin. Some antidepressants, such as amitriptyline or nortriptyline, may help certain people.
In severe cases, when pain is difficult to treat, surgery to take pressure off the glossopharyngeal nerve may be needed. Or, the nerve can be cut (rhizotomy). Both surgeries are generally considered effective. If a cause of the neuralgia is found, treatment should control the underlying problem.
Expectations (prognosis)How well you do depends on the cause of the problem and the effectiveness of the first treatment. Surgery is considered effective for people who do not benefit from medications.
ComplicationsSlow pulse and fainting may occur when pain is severe.
Medications used to treat this condition can have side effects.
Calling your health care providerCall your health care provider if you have symptoms of glossopharyngeal neuralgia. See a pain specialist if the pain is severe to be sure that you are aware of all your options for controlling pain.
ReferencesCutrer FM, Moskowitz MA. Headaches and other head pain. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 421.
Ferroli P, Fioravanti A, Schiariti M, Tringali G, Franzini A, Calbucci F, Broggi G. Microvascular decompression for glossopharyngeal neuralgia: a long-term retrospectic review of the Milan-Blogna experience in 31 consecutive cases. Acta Neuochir (Wien). 2009;151:1245-1250.
Reviewed ByReview Date: 05/05/2010
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Carbamazepine , phenytoin, gabapentin , baclofen, and tricyclic antidepressants may be used to ameliorate the pain of glossopharyngeal neuralgia.
Glossopharyngeal neuralgia may be due to inflammation or compression of either the glossopharyngeal nerve or the vagus nerve, another nerve that innervates (stimulates) the same basic areas.
Glossopharyngeal neuralgia is a chronic pain syndrome that causes intense, shooting pains in the back of the tongue and throat, tonsillar areas, and middle ear.
Glossopharyngeal neuralgia causes sudden, intense pains in the throat, mouth, tongue, jaw, ear, and neck. The pains have been described as excruciating and electric shock-like.
Glossopharyngeal, trigeminal, and postherpetic neuralgias sometimes respond to anticonvulsant drugs, such as carbamazepine or phenytoin, or to painkillers, such as acetaminophen. Trigeminal neuralgia may also be relieved by surgery.
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The second syllable of neuralgia is accented.
Trigeminal neuralgia tends to come and go, but successive attacks may be disabling. Although neuralgia is not fatal, the patient's fear of being in pain can seriously interfere with daily life. Some people with postherpetic neuralgia.
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