Glossopharyngeal Neuralgia

This article provides an in-depth overview of Glossopharyngeal Neuralgia (GPN), a condition characterized by paroxysmal pain in areas innervated by the glossopharyngeal and vagus nerves. It highlights the clinical similarities and differences between GPN and trigeminal neuralgia, including the common triggers and bilateral involvement in some patients. The article discusses diagnostic procedures like MRI/MRA and outlines the pharmacological therapies used for managing GPN, mirroring those for trigeminal neuralgia. Additionally, the article explores surgical treatment options for cases where medical therapy is ineffective.

Clinical Presentation of Glossopharyngeal Neuralgia

GPN is characterized by severe, paroxysmal, stabbing pain involving the ear, tonsillar fossa, base of the tongue, or beneath the jaw angle. Pain typically radiates from the oropharynx to the ear, with triggers including chewing, swallowing, and touching the neck.

Diagnosis and Medical Treatment

MRI/MRA is indicated to exclude space-occupying lesions or vascular pathology. The first-line treatment for GPN involves carbamazepine or oxcarbazepine, with gabapentin or lamotrigine as alternatives for those who do not respond to initial treatment. Baclofen and pimozole serve as adjunctive therapies.

Surgical Treatment Options

Surgical interventions are considered for patients who fail medical treatment and may include intracranial sectioning of cranial nerves, gamma knife radiosurgery, or vascular decompression.

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