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Laryngeal neuralgia.
Last reviewed: 05.07.2025
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Glossopharyngeal neuralgia is a recurrent attack of severe pain in the innervation zone of the IX pair of cranial nerves (posterior wall of the pharynx, posterior 1/3 of the tongue, middle ear).
The diagnosis of glossopharyngeal neuralgia is made clinically. Treatment of glossopharyngeal neuralgia with carbamazepine or gabapentin.
[ Causes of glossopharyngeal neuralgia
Like trigeminal neuralgia and hemifacial spasm, glossopharyngeal neuralgia is sometimes associated with compression of the nerve by a pulsating artery. Rarely, the cause is a tumor of the cerebellopontine angle or neck. The cause of the disease is not always found. It is rare, mainly in men over 40 years of age.
Symptoms of glossopharyngeal neuralgia
As with trigeminal neuralgia, the symptoms of glossopharyngeal neuralgia are as follows: paroxysmal attacks of unilateral short-term severe pain occur spontaneously or are provoked by certain movements (e.g., chewing, swallowing, talking, sneezing). The pain usually occurs in the tonsil area or at the base of the tongue and can radiate to the ear, lasting from a few seconds to several minutes. In 1-2% of cases, a parallel increase in the activity of the vagus nerves leads to sinus arrhythmia (pauses) with the development of fainting. Such episodes can be repeated often.
Where does it hurt?
Diagnosis of glossopharyngeal neuralgia
The diagnosis of glossopharyngeal neuralgia is made based on clinical data. Differentiation with trigeminal neuralgia is carried out according to the following criteria: different localization of pain, with glossopharyngeal neuralgia, swallowing or touching the tonsils with a spatula provokes pain, and irrigation of the throat with lidocaine temporarily eliminates spontaneous or provoked pain. Tumors of the tonsils, pharynx and cerebellopontine angle, as well as metastatic lesions of the anterior neck area are excluded by MRI.
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Treatment of glossopharyngeal neuralgia
Treatment of glossopharyngeal neuralgia is the same as for trigeminal neuralgia. If treatment of glossopharyngeal neuralgia is ineffective, pharyngeal applications of cocaine may provide a temporary effect. Surgery may be required to decompress the nerve. If the pain is limited to the pharynx, surgery is performed on the extracranial part of the nerve, and if the pain is widespread, on the intracranial part.
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