Glossopharyngeal Neuralgia

What is glossopharyngeal neuralgia?

Glossopharyngeal neuralgia (GPN or GN) is a relatively rare condition, occurring in less than one person in 100,000. The glossopharyngeal nerve is the 9th cranial nerve. It is responsible for feeling in the tongue and throat and movements such as swallowing and the gag reflex, along with others. “Glosso-” means related to the tongue; “pharyngeal” means related to the pharynx, or throat. The pain of GPN is typically severe, brief, sudden, and recurrent pain in the ear, base of the tongue, tonsils or beneath the angle of the jaw. Clusters of one-sided sharp, stabbing, pain shooting from throat to ear, or vice versa is characteristic of GPN. You may also feel an aching pain in the same area which persists. The pain can be present for years and may have spontaneous remissions. The pain attacks usually last for no more than two minutes. The sudden, brief episodes of GPN can be mistaken for trigeminal neuralgia.

Commonly, attacks occur during the day and can be triggered by movements of the jaw, such as swallowing, cold liquids, chewing, talking, sneezing, and clearing the throat. Touching the area and even sudden movements of the head can trigger GPN attacks. For some people, eating particular foods- sweet, spicy, or sour can trigger GPN.

Additional rare symptoms

  • Tinnitus (ringing, noise in the ear)
  • Vomiting
  • Vertigo
  • Swelling
  • Involuntary movements

Diagnosing glossopharyngeal neuralgia

Diagnosis for GPN is made through your explanation of your symptoms and an examination by your doctor. Because GPN can appear similar to trigeminal neuralgia, it is important for your doctor to exclude TN and other causes of pain due to inflammation or growths. Your doctor will also map out your pain to understand if it is typical GPN or involves other cranial nerves. Laboratory tests may be given to rule out underlying disease. MRI, MRA, and other imaging tests of the head or neck may be used to rule out nerve compression or tumors.

What causes glossopharyngeal neuralgia?

Most cases of GPN happen spontaneously or no cause is found. In some cases, it is caused by compression of the nerve by tumors, malformations, vascular compression, multiple sclerosis (MS), infection, or trauma.

How is glossopharyngeal neuralgia diagnosed? 

Your doctor will perform an examination of your head and neck, ask you to explain your symptoms and history, and order tests, including an MRI to rule out underlying causes such as trigeminal neuralgia, tumor or underlying disease.

Treatment of glossopharyngeal neuralgia

  • Medications including anti-seizure drugs such as carbamazepine, gabapentin, and pregabalin
  • Vitamin B12
  • Glossopharyngeal nerve block, which may also confirm a GPN diagnosis if successful
  • Surgery, including microvascular decompression (MVD) and rhizotomy
  • Gamma Knife (radiation) surgery

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