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Glossopharyngeal Neuralgia Treatment

The rare pain syndrome called glossopharyngeal neuralgia (GN) affects the glossopharyngeal nerve, which is the ninth cranial nerve deep inside the neck. GN causes sharp, stabbing feelings of pain in the tonsils, throat, middle ear and tongue. The pain is excruciating and can last anywhere from a couple of seconds to a few minutes. People who suffer from it may go weeks without pain, or they may be struck several times per day. It depends on the person.

  1. About

    • GN usually hits people as they perform some sort of trigger factor. Swallowing can cause an attack. In addition, coughing, talking, drinking a cold beverage, sneezing, clearing the throat or touching the inside of the mouth can cause the pain. Many times, GN is caused by the compression of the glossopharyngeal nerve but there may not be an evident cause. It is linked to multiple sclerosis, much like trigeminal neuralgia, and usually affects people over the age of 40.

      CAT scans, X-rays or an MRI should be done to see if there's an abnormality at the base of the skull such as tumors. An MRI may show an inflammation of the glossopharyngeal nerve. To determine whether a blood vessel is pushing on the nerve, magnetic resonance angiography (MRA) or conventional angiography should be used to get pictures of the brain arteries. Blood tests can help doctors diagnose whether there are other causes of peripheral nerve problems like high blood sugar.

    Treatment

    • Most doctors will try to treat Glossopharyngeal Neuralgia with pain drugs. Over-the-counter drugs are usually not effective. However, anticonvulsant drugs such as gabapentin and carbamazepine work on many people. If patients don't respond to the drugs, there are surgical options including tractotomy, nerve resection or microvascular decompression. These options usually work to end the pain but may cause sensory loss in the tongue, mouth or throat.

    Prognosis

    • Some people have one pain attack and that's it. Others will get clusters of attacks separated by long or short periods of remission. There can be other effects, as well. If chewing, eating or drinking trigger a GN pain attack, people may fear doing these things and lose weight. As of 2009 the National Institute of Neurological Disorders and Stroke (NINDS) is doing research on GN, in its clinics and labs through the National Institutes of Health. NINDS also gives grants to major medical facilities across the country for research. Much focuses on discovering better ways to prevent, treat, and disorders such as GN.

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