Glossopharyngeal neuralgia
Glossopharyngeal nerve neuralgia are recurring attacks of severe pain in the back of the throat, the area near the tonsils, the back of the tongue, part of the ear, and/or the area under the back of the jaw. The pain is due to malfunction of the 9th cranial nerve (glossopharyngeal nerve)
Epidemiology
Glossopharyngeal neuralgia (GPN) (a.k.a. vagoglossopharyngeal neuralgia) is a rare condition, with an estimated incidence of 0.8 cases per 100,000 persons per year 1).
Predilection among females, principally within the fifth decade of life 2).
Corresponds to 0.2-1.3% of all facial pain syndromes 3).
GPN occurs more frequently on the left side and involvement is bilateral (not simultaneously) in only 2% of the cases 4).
Classification
The GPN can be classified by the clinical features, including the classic GPN (episodic pain) and the symptomatic GPN (continuous pain), and the second is classified by the etiology, including an idiopathic origin or a secondary nature (e.g., tumor, neurovascular compression) 5).
Etiology
The cause is often unknown but sometimes is an abnormally positioned artery that puts pressure on (compresses) the glossopharyngeal nerve, where the nerve exits the brain stem.
Clinical features
Diagnosis
The diagnosis of GPN is primarily clinical, and complimentary imaging can be performed, including computed tomography (CT) or magnetic resonance imaging (MRI) scans, which can reveal adjacent tumors, neurovascular conflicts, arteriovenous malformations (AVMs), demyelinating lesions, or an elongated styloid process involving the IX and X cranial nerves (CN) 6).