Glossopharyngeal Neuralgia

The pathophysiology of glossopharyngeal neuralgia (GN) is similar to that of TN because the pain characteristics are so remarkably similar. Most cases are idiopathic, although vascular compression has been described. y Secondary GN may be due to oropharyngeal malignancies, peritonsillar infection, an osteophytic stylohyoid ligament, and carotid aneurysm. The incidence of GN is reported between 1/70 and 1/100 the incidence of TN. y The pain of GN is similar to that of TN, although a few patients experience a dull pain that persists for minutes or hours. The pain is located in the ear, tonsil, larynx, tongue, or combinations of these areas. Triggers include swallowing, chewing, or talking. Coughing may accompany the pain. Anesthetizing the throat may temporarily relieve the pain. Unlike TN, MS has not been associated with GN. The differential diagnosis of GN includes TN, geniculate neuralgia, and neck/tongue syndrome. MRI of the brain, x-ray studies to visualize the stylohyoid ligament and styloid process, and careful examination of the pharynx are indicated when evaluating the patient with a present diagnosis of GN. Medical management is identical to the treatment of GN. Surgical options include ablation of the glossopharyngeal nerve and microvascular decompression.

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