Glossopharyngeal Neuralgia

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.

Symptoms

Intermittent severe lancinating pain in the back of throat and inside of the ear on one side
Pain free intervals in between attacks
Can be associated with episodes of low heart rate or fainting spells

Causes

Glossopharyngeal neuralgia is usually the result of:

A blood vessel pressing on the glossopharyngeal nerve (9th cranial nerve)
Tumor (rare)

Risk Factors

There are no known risk factors for the condition

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

Complete examination of the oropharynx may be performed
Images of the head may be taken with an MRI or CT scan

Prevention

There are no current guidelines to prevent glossopharyngeal neuralgia

Resources

Treatment

Talk with your doctor about the best treatment plan for you.

Initial treatment may include anticonvulsant medications such as carbamazepine or gabapentin
Surgical microvascular decompression is an effective long term treatment
Glossopharyngeal rhizotomy is sometimes used

Figure 1 shows the location of the pain in most cases which is in the back of the throat and can also be inside the ear canal

Figure 2 shows the surgical incision used to decompress the glossopharyngeal nerve

Figure 3 shows the typical intraoperative findings showing a vessel which is deforming the glossopharyngeal and or vagus nerve

Figure 4 shows the nerve after the vessel is moved

Figure 5 shows the teflon pledget which is placed to protect the nerve from further contact with the vessel

Figure 6 shows published results of the effectiveness of treatment

Video

David Newell, M.D. talks about the steps to perform a microvascular decompression of the glossopharyngeal or 9th cranial nerve for severe throat and ear pain from glosspharyngeal neuralgia.

Warning: this video contains graphic depictions of neurosurgery.

Glossopharyngeal Neuralgia is a rare pain syndrome that affects the glossopharyngeal nerve. For help with symptoms, pain, risks, and treatment contact us or see Seattle Neurosciences’ website.

Dr. Newell was born in Boston, MA and attended Case Western Reserve University medical school. He then completed his residency in neurosurgery at the University of Washington, including one year in London at St. George’s medical school. Dr. Newell is the co-founder of the Swedish Neuroscience Institute and founder of the Seattle Neuroscience Institute.