Glossopharyngeal neuralgia (GN) is a rare pain syndrome that affects the glossopharyngeal nerve (the ninth cranial nerve that lies deep within the neck) and causes sharp, stabbing pulses of pain in the back of the throat and tongue, the tonsils, and the middle ear. The excruciating pain of GN can last for a few seconds to a few minutes, and may return multiple times in a day or once every few weeks. Many individuals with GN relate the attacks of pain to specific trigger factors such as swallowing, drinking cold liquids, sneezing, coughing, talking, clearing the throat, and touching the gums or inside the mouth. GN can be caused by compression of the glossopharyngeal nerve, but in some cases, no cause is evident. Like trigeminal neuralgia, it is associated with multiple sclerosis. GN primarily affects the elderly.
Is there any treatment?
Doctors at BRAINS will use a range of test and scans to diagnose the condition. The objective of the tests would be to confirm the disease and equally to rule out other causes for the symptoms. Also advised would be CT and MRI scans and x-rays of the head or the neck.
The goal of treatment is to control pain. Over-the-counter painkillers such as aspirin and acetaminophen (Tylenol) are not very effective for relieving glossopharyngeal neuralgia. The most effective are anti-seizure and anti-depressant medications.In severe cases, when pain is difficult to treat, surgery to take pressure off the glossopharyngeal nerve may be needed. This is called microvascular decompression. Or, the nerve can be cut (rhizotomy). Both surgeries are generally considered effective. If a cause of the neuralgia is found, treatment should control the underlying problem. How well you do depends on the cause of the problem and the effectiveness of the first treatment. Surgery is considered effective for people who do not benefit from medications.Surgical options, including nerve resection, tractotomy, or microvascular decompression, should be considered when individuals either don’t respond to, or stop responding to, drug therapy. Surgery is usually successful at ending the cycles of pain, although there may be some sensory loss in the mouth, throat or tongue.
Blood tests: to check your erythrocyte sedimentation rate — commonly referred to as the sed rate. Will be used to gauge sugar levels and to look for the causes of nerve damage
MRI: An MRI machine uses radio waves and a strong magnetic field to produce detailed images of your brain. You lie on a narrow table that slides into the tube-shaped MRI machine, which makes loud banging noises during scans. The entire procedure can take an hour or more. MRIs are painless, but some people feel claustrophobic in the machine.Sometimes the MRI may show swelling (inflammation) of the glossopharyngeal nerve.To find out whether a blood vessel is pressing on the nerve, pictures of the brain arteries may be taken using Magnetic resonance angiography (MRA), CT angiogram or X-rays of the arteries with a dye (conventional angiography).
Computerized tomography (CT): For a brain CT scan, you lie on a narrow table that slides into a small chamber. X-rays pass through your head from various angles, and a computer uses this information to create cross-sectional images, or slices, of your brain. The test is painless and takes about 20 minutes.