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Glossopharyngeal Neuralgia

Last Updated: August 23, 2018

Microvascular decompression for glossopharyngeal neuralgia: Technique

Glossopharyngeal neuralgia (GN) is a very rare pain disorder characterized by severe, lancinating, paroxysmal pain in the areas supplied by the auricular and pharyngeal branches of cranial nerves (CN’s) IX and X. The affected regions can include the external ear canal, base of the tongue, tonsillar pillars, posterior pharynx, and the area beneath the angle of the jaw.

Common triggers include speaking, swallowing, eating, breathing, cold air, and other cutaneous stimuli of the mouth and pharyngeal region. Occasionally these paroxysmal attacks are accompanied by hemodynamic instability, syncope, asystole, and convulsions, leading to the condition called vagoglossopharyngeal neuralgia.

Glossopharyngeal neuralgia is 100 times less common than trigeminal neuralgia, generally affects patients in their 5th decade of life, and most often involves the left side. In 2% of sufferers, it presents bilaterally.

The International Headache Society recently proposed a subclassification of GN that includes classical and symptomatic forms. In the classical type, the pain is on...