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GLOSSOPHARYNGEAL NEURALGIA 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.A comprehensive review of this subject is available in monograph form on this website. DIAGNOSIS 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 Medical Treatment 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.Surgical Treatments 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.Alternative Treatments 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 methods.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 Brainstem.
Additional Information Please consult our comprehensive monograph on this subject in our Downloads and Information Library.A video of this operation is available in our Video Library
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All content ©2024 by Neurosurgical Consultants, P.A. Author, Martin L. Lazar, MD, FACS All Rights Reserved. See Usage Notices. |