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Glossopharyngeal Neuralgia

Glossopharyngeal Neuralgia

Glossopharyngeal neuralgia (GPN) is characterized by recurring episodes of severe pain in the tongue, throat, ear, and area near the tonsils. These painful episodes may be brief and intermittent, lasting from a few seconds to a few minutes—but the pain is excruciating. The condition is a rare disorder, most often afflicting patients over age 40, and more common in men than women.

Symptoms of Glossopharyngeal Neuralgia

The primary symptom of glossopharyngeal neuralgia is severe pain in areas connected to the ninth cranial nerve, including the back of the throat, the tonsillar region, the back 1/3 of the tongue, the back of the nose, the larynx, and the ear.  Attacks of GPN can be triggered by a particular action like chewing, swallowing, speaking, coughing, or sneezing.

Causes of Glossopharyngeal Neuralgia

GPN results from irritation of the ninth cranial nerve, but in some cases, the source of irritation is never found. Potential causes of the condition include nerve compression by:

  • Abnormal artery position
  • Unusually long styloid process (the pointed bone at the base of the skull)
  • Blood vessels pressing on the glossopharyngeal nerve
  • Growths or lesions at the skull base
  • Tumors or infections of the throat & mouth

Glossopharyngeal neuralgia is very similar to trigeminal neuralgia and is sometimes misdiagnosed by physicians who have little experience with the condition.

Diagnosing Glossopharyngeal Neuralgia

A variety of tests are used to identify neuralgia problems. These tests include magnetic resonance imaging (MRI), CT scans, and x-rays. GPN can sometimes be identified by a physical “trigger” where the doctor touches the nerve area. If this test suggests glossopharyngeal neuralgia, an MRI will almost certainly be indicated.

Treatment for Glossopharyngeal Neuralgia

Treatments for glossopharyngeal neuralgia range from conservative, non-surgical drug therapy for pain management to microvascular decompression surgery when pain management becomes ineffective.

  • Drugs: Anti-seizure drugs like carbamazepine, gabapentin, or pregabalin have proven effective for some patients. One drawback to drug therapy is diminishing effectiveness as patients build a drug tolerance.
  • Nerve blocks: Injections of local anesthetics, steroids or neurolytic agents (phenol, alcohol, glycerol, etc.) can provide relief from neuralgia pain. The initial use of a block is often part of the confirmation of a GPN diagnosis.
  • Microvascular decompression surgery: A surgical procedure called microvascular decompression may provide permanent relief of neuralgia pain if drug therapy fails. This procedure is an advanced procedure and should only be performed by a skilled, experienced neurosurgeon like those at Princeton Brain, Spine & Sports Medicine.

Leading Edge Surgical Procedures From Princeton Brain, Spine & Sports Medicine

When a glossopharyngeal neuralgia diagnosis requires microvascular decompression, turn to PBSSM neurosurgeon Mark McLaughlin, MD, FACS. Dr. McLaughlin trained with Peter Jannetta, MD, the father of modern microvascular decompression surgery for neuralgias and other cranial nerve rhizopathies. Dr. McLaughlin is also a research pioneer in this area, serving as lead author of the paper, “Microvascular Decompression of Cranial Nerves: Lessons Learned after 4400 Operations” published in the Journal of Neurosurgery in January 1999.

As one of the highly trained Princeton Brain, Spine & Sports Medicine neurosurgeons practicing patient-focused medicine in our NJ and PA offices, Dr. McLaughlin is also an expert in the treatment of trigeminal neuralgia. To request a consultation with Dr. McLaughlin about glossopharyngeal neuralgia or possible neuralgia symptoms, call 215.741.3141 in PA, 609.921.9001 in NJ. For the convenience of our patients, we are also available by online message.

Additional Resources

Treatment Options for Glossopharyngeal Neuralgia – Video by Dr. McLaughlin

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