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​Glossopharyngeal Neuralgia

Glossopharyngeal neuralgia is a rare pain syndrome that affects the glossopharyngeal nerve. Pain is found in the throat, tongue, tonsils, and middle ear.

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What is Glossopharyngeal Neuralgia?

Glossopharyngeal neuralgia is characterized by a sharp, jabbing pain deep in the throat, or in the tongue, ear, and tonsils, lasting a few seconds to a few minutes.

Glossopharyngeal neuralgia is generally caused by a small blood vessel that presses on the nerves as they exit the brainstem. This condition is caused by irritation of the ninth cranial nerve by a blood vessel, and is most commonly seen in people over age 40.

Before recommending surgery, doctors will typically prescribe medicine to treat glossopharyngeal neuralgia.

If you do require surgery, UPMC's neurosurgeons may perform microvascular decompression.

Diagnosing Glossopharyngeal Neuralgia

Your physician will perform a physical exam and will ask about your symptoms.

Glossopharyngeal neuralgia symptoms

Symptoms of glossopharyngeal neuralgia may include severe pain in areas connected to the ninth cranial nerve, which are:

  • Nasopharynx, or back of the nose and throat
  • Back of the tongue
  • Ear
  • Tonsil area
  • Larynx or voice box

The pain can be triggered by:

  • Chewing
  • Coughing
  • Laughing
  • Speaking
  • Swallowing

Glossopharyngeal neuralgia complications

Complications may include:

  • Slow pulse and fainting may occur when pain becomes severe
  • Medications used to treat this condition may have side effects

Testing for glossopharyngeal neuralgia

Doctors usually obtain an MRI scan for people with these symptoms to rule out tumors or other lesions.

Glossopharyngeal Neuralgia Treatments

Medications

Medications can provide relief to patients with glossopharyngeal neuralgia, but many people require increasing doses, which can lead to difficult side effects. When this happens, one treatment option at UPMC is microvascular decompression.

Surgery: Microvascular Decompression

Microvascular decompression is a minimally invasive surgical procedure that relieves abnormal compression of a cranial nerve. The surgery consists of a linear incision behind the ear followed by a craniectomy (bony opening) the size of a silver dollar.

Under the view of a microscope or endoscope, the doctors detect the area where the blood vessel is affecting the nerve and then separate them, leaving a Teflon "pillow" in between.

Microvascular decompression is considered the most effective glossopharyngeal neuralgia treatment. Despite the rarity of glossopharyngeal neuralgia, UPMC specialists have operated on more than 200 people, with more than 80 percent reporting immediate and satisfactory results.