Glossopharyngeal Neuralgia

The glossopharyngeal nerve is a cranial nerve that supplies the tongue and the throat. It is the ninth cranial nerve. Inflammation and irritation of the glossopharyngeal nerve can result in a condition known as glossopharyngeal neuralgia. In this article we take a look at this condition in a little more detail.

What is Glossopharyngeal Neuralgia?

Glossopharyngeal neuralgia is irritation of the glossopharyngeal nerve that results from a number of different causes. The growth of extra blood vessels close to the nerve is one such cause. Infection of the nerve fibres is another cause. Sometimes, a tumour or soft tissue growth can compress the nerve fibres resulting in glossopharyngeal neuralgia.

What are the Clinical Symptoms?

The clinical symptoms are all due to irritation of the nerve fibres and present in areas where the nerve fibre supplies.

The common symptom experienced is pain. This may be either at the back of the tongue, the throat, over the tonsils and in the ears. There may be pain when speaking. The symptoms tend to be episodic and may range from mild to severe. They may occur on both sides of the throat or just one side. Symptoms may be worsened by acts of swallowing, speaking and coughing.

How is a Condition Diagnosed?

If a clinical diagnosis of glossopharyngeal neuralgia is made, patients often require different tests to determine the exact cause of the condition. Some other commonly performed tests include a blood sugar level, CT scan or MRI scan of the brain and occasionally specialist magnetic resonance angiography tests. Patients with diabetes may be at higher risk which is why the blood sugar level is checked. An MRI scan can help view the nerve clearly and can determine any problems with how it functions.

How is a Condition Treated?

The first line therapy in glossopharyngeal neuralgia is painkillers. However, simple over-the-counter painkillers such as non-steroidal anti-inflammatory drugs and paracetamol are rarely helpful. Drugs such as anticonvulsants medication is used in low doses as these have powerful painkilling properties. These drugs include gabapentin and carbamazepine.

In patients in whom medical therapy is not helpful, surgical options may need to be sought after. These include nerve resection or microvascular decompression of the glossopharyngeal nerve. These are specialist procedures and are often performed by expert surgeons.

While most patients have some form of relief with medical therapy, often the pain can be quite severe and may warrant the requirement for surgical measures.

In the long-term, patients may only have one episode and may not have another episode for the rest of their lives. However, some people may experience bursts of pain time and again which can have quite a detrimental impact on the individual’s quality of life.

Conclusion

Glossopharyngeal Neuralgia is a painful condition that can arise due to numerous causes. Simple investigations can aid diagnosis but treatment can be rather difficult. Specialist input is often required in managing this condition.