Glossopharyngeal Neuralgia is a very painful condition, similar in
severity to Trigeminal Neuralgia. In this case it is the
Glossopharyngeal (or 9th Cranial) Nerve that is involved with the
excruciatingly sharp stabbing pain being experienced in the back of
the throat and deep in the ear region. It may originate with
the act of swallowing. Once again, the cause is a pressure
injury (usually by a blood vessel) to the Glossopharyngeal
Nerve, as it enters the Brainstem.
comprehensive review of
this subject is available in monograph form on this website.
It is as imperative here as it is in patients with Trigeminal Neuralgia to
make certain that an MRI ("Thin Slice Technology") and MRA
(Angiogram) has been done to identify the vital anatomical
relationships of the nerves and blood vessels as well as to rule out a
life-threatening problem such as a Brain Tumor or an Aneurysm.
Treatment with the anticonvulsant medications such as Tegretol and/or
Neurontin is a reasonable first attempt to relieve this severe pain.
Unfortunately these drugs are not nearly as effective for
Glossopharyngeal Neuralgia as they are for Trigeminal Neuralgia.
In those patients where medical treatment (usually with Tegretol
and/or Dilantin) fails, Microvascular Decompression (MVD)
treatment is the recommended treatment since it allows the Neurosurgeon to
"decompress" the Glossopharyngeal Nerve. This operation is
more technically demanding compared with that for
Trigeminal Nerve MVD. There are unusual occasions, usually related
to a peculiar anatomical anomaly of the offending arteries where
microvascular decompression is not possible. In these rare instances, the
fibers of the Glossopharyngeal (9th Cranial) Nerve and
the upper two or three fibers of the adjacent Vagus (10th Cranial)
Nerve are cut. This would result in numbness in the back of the
throat and paralysis of some of the muscles in the back of the interior
of the mouth and throat on the one side. These nerves are cut only
when decompression proves to be impossible since it is imperative to
relieve this excruciating pain. Once again, the surgical
results are quite gratifying and have proven to be reliable over long
periods of time.
There are no effective Percutaneous techniques available for
Glossopharyngeal Neuralgia as there are for Trigeminal Neuralgia since the
Glossopharyngeal Nerve is not accessible using Percutaneous
Radiosurgery alternatives are generally not available
due to the limitations of that technology and the anatomy of the
Glossopharyngeal Nerve relative to other Cranial Nerves and the
Please consult our comprehensive monograph on this subject in our
Downloads and Information Library.
A video of this operation is available in our
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This page last edited on 2/19