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  3. Glossopharyngeal neuralgia
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Glossopharyngeal neuralgia


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Summary Summary


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Glossopharyngeal neuralgia is a disorder that is associated with repeated episodes of severe pain in the tongue, throat, ear, and tonsils. These areas are all connected to the ninth cranial nerve, also called the glossopharyngeal nerve. Episodes of pain may last from a few seconds to a few minutes and usually occur on one side of the face. The pain may be triggered by swallowing, speaking, laughing, chewing, or coughing.[1]

Glossopharyngeal neuralgia is thought to be caused by irritation of the glossopharyngeal nerve, but the exact cause of the irritation is sometimes unknown.[1] Laboratory and imaging tests can be used to diagnose the disorder and rule out serious underlying problems. The goal of treatment is to control pain, and the most effective drugs are anti-seizure medications and anti-depressants. Surgery to sever or take pressure off of the glossopharyngeal nerve may be needed in severe cases.[1]
Last updated: 11/18/2017

Symptoms Symptoms


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Glossopharyngeal neuralgia causes repeated episodes of severe pain in areas connected to the ninth cranial nerve, also known as the glossopharyngeal nerve. These areas include the back of the nose and throat, back of the tongue, ear, tonsil area, and voice box. Some episodes may also be associated with coughing or hoarseness. Episodes may last for seconds or a few minutes, and they may occur many times throughout the day and night. Episodes may be triggered by coughing, sneezing, swallowing, talking, laughing, or chewing.[1][2][3]

Symptoms of glossopharyngeal neuralgia typically occur in individuals over 40 or 50-years-old.[1][2] Pain usually begins at the back of the tongue or throat, and it sometimes spreads  to the ear or the back of the jaw. The pain can cause difficulty speaking and swallowing. In rare cases, the disorder can cause a slow heart rate (bradycardia), hypotension, no heart beat due to cardiac arrest (asystole), or fainting (syncope).[1][2][4]
Last updated: 6/6/2018
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Cause Cause


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Glossopharyngeal neuralgia is thought to be caused by irritation of the glossopharyngeal nerve. In many cases, the source of the irritation is not found.[1][2] In some cases, the source of the irritation is found to be increased pressure on the glossopharyngeal nerve, such as an abnormally positioned artery, growths at the base of the skull, an infection, an injury, or tumors of the throat, mouth, or brain.[1][2] Rarely, the disorder may be caused by an aneurysm in the carotid artery, an abnormally long bone below the ear (styloid process), or multiple sclerosis.[2]
Last updated: 11/18/2017

Inheritance Inheritance


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In most cases, glossopharyngeal neuralgia is caused by irritation of the glossopharyngeal nerve and is not inherited (passed down from parent to child). In most cases, a person with glossopharyngeal neuralgia is the only person with the disorder in the family. However, if the underlying cause of the disorder runs in families, there may be more than one family member with the disorder.[2] 
Last updated: 11/18/2017

Diagnosis Diagnosis


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A diagnosis of glossopharyngeal neuralgia is suspected when a person presents to the doctor with symptoms of the disorder. A test can then be completed in which a cotton swab is touched to the back of the throat. This typically causes pain in people with glossopharyngeal neuralgia, but the pain is relieved when a local anesthetic is applied.[2]

After glossopharyngeal neuralgia is diagnosed, doctors may try to determine the underlying cause of the pain. Tests such as a blood test, CT scan, MRI, or X-rays may be ordered. If it is suspected that there may be problems with the blood vessels, an MR-angiogram (MRA) may also be ordered.[1][2]
Last updated: 11/18/2017

Treatment Treatment


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Treatment for glossopharyngeal neuralgia is aimed at controlling the pain associated with the disorder. Over-the-counter pain medications are generally not very effective at controlling the pain. However, anti-seizure medications and anti-depressants may help relieve pain for some individuals.[1][2] The application of local anesthetics to the affected region may also help control pain, but typically only for a short time.[3] If an underlying cause for the disorder is identified, treatment is generally aimed at treating the underlying problem.[1]

In severe cases, surgery may be necessary to remove pressure from the glossopharyngeal nerve. This may involve removing the cause of the pressure on the nerve or severing the nerve so that it no longer causes pain.[1]
Last updated: 11/18/2017

Prognosis Prognosis


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The long-term outlook for people affected by glossopharyngeal neuralgia may depend on the underlying cause of the disorder and the response to treatment. Some people with the disorder respond well to medications that help control the pain such as anti-seizure medications and anti-depressants. If medications are not successful, surgery is typically able to relieve the pain. In some cases, side effects of surgery may include loss of sensation in the mouth and throat.[5]

Some people with glossopharyngeal neuralgia have just one episode of pain, others may have episodes that occur in clusters with periods in between without any episodes of pain. For some individuals, the episodes of pain may occur daily.[5] People who have glossopharyngeal neuralgia and experience frequent pain that medications are not able to control are encouraged to speak with their doctors about surgical options.
Last updated: 11/18/2017

Organizations Organizations


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Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

  • American Chronic Pain Association (ACPA)
    P.O. Box 850
    Rocklin, CA 95677-0850
    Toll-free: 800-533-3231
    Telephone: 916-632-0922
    Fax: 916-652-8190
    E-mail: ACPA@theacpa.org
    Website: https://theacpa.org/
  • Facial Pain Association
    22 SE Fifth Ave., Suite D
    Gainesville, FL 32601
    Toll-free: 1-800-923-3608
    Telephone: +1-352-384-3600
    Fax: +1-352-384-3606
    E-mail: info@tna-support.org
    Website: https://fpa-support.org/
  • Pain Relief Foundation
    Clinical Sciences Centre
    University Hospital Aintree, Lower Lane
    Liverpool L9 7AL
    United Kingdom
    Telephone: 0151 529 5820
    Fax: 0151 529 5821
    Website: https://painrelieffoundation.org.uk/

Organizations Providing General Support

  • American Pain Society
    8735 W. Higgins Road
    Suite 300
    Chicago, IL 60631
    Telephone: 847-375-4715
    E-mail: info@americanpainsociety.org
    Website: http://americanpainsociety.org
Do you know of an organization? We want to hear from you.

Learn More Learn More


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These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
  • The Merck Manuals Online Medical Library provides information on this condition for patients and caregivers. 
  • The National Institute of Neurological Disorders and Stroke (NINDS) collects and disseminates research information related to neurological disorders. Click on the link to view information on this topic.

In-Depth Information

  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Glossopharyngeal neuralgia. Click on the link to view a sample search on this topic.

GARD Answers GARD Answers


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Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

Have a question? Contact a GARD Information Specialist.

References References


  1. Shelat AM. Glossopharyngeal neuralgia. MedlinePlus. May 30, 2016; http://www.nlm.nih.gov/medlineplus/ency/article/001636.htm.
  2. Rubin M. Glossopharyngeal Neuralgia. Merck Manuals. February 2016; http://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/cranial-nerve-disorders/glossopharyngeal-neuralgia.
  3. Bajwa ZH, Ho CC, Khan SA, and Garza I. Overview of craniofacial pain. UpToDate. April 25, 2017; https://www.uptodate.com/contents/overview-of-craniofacial-pain.
  4. Krasoudakis A, Anyfantakis D, Hadjipetrou A, et al. Glossopharyngeal neuralgia associated with cardiac syncope: Two case reports and literature review. Int J Surg Case Rep. 2015; 12:4-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485693/.
  5. Glossopharyngeal Neuralgia Information Page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Glossopharyngeal-Neuralgia-Information-Page. Accessed 11/12/2017.
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