Glossopharyngeal Neuralgia (GPN) symptoms manifest in the throat, tonsils, tongue, ear, and voice box. This is a rare condition that derives from the glossopharyngeal nerve, also known as the ninth cranial nerve. Additionally, the spasmodic, painful episodes usually last from a few seconds, to a few minutes. Normally, the pain occurs on only one side of the face, and happens while coughing, chewing, laughing, swallowing, or speaking.
Glossopharyngeal neuralgia causes include an irritation to the glossopharyngeal. However, finding the cause of the irritation is sometimes difficult. While the exact cause is not known, it is often a blood vessel that compresses the nerve. Interestingly, the glossopharyngeal neuralgia symptoms usually occur in people 40-50 years of age. Moreover, it occurs more often in men.
Usually, glossopharyngeal neuralgia symptoms begin at the back of the tongue and throat, and then continue to the ear or jaw. Unfortunately, this causes difficulty in speaking, and swallowing. Although it rarely occurs, sometimes it leads to hypotension, fainting, low heart rate, or cardiac arrest.
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GPN Causes
In most patients, the cause is an artery that compresses the glossopharyngeal nerve, where it appears from the brainstem. In other cases, the long, pointed bone at the base of the skull gets too long, and presses against the nerve.
Other glossopharyngeal neuralgia causes, although rare, include abscesses, an aneurysm of the artery in the neck, brain or neck tumors, or multiple sclerosis.
In addition, central nervous system, or spinal cord issues, may also contribute to damage of the nerve and glossopharyngeal neuralgia.
Other illnesses, such as diabetes or any other neuropathy that causes nerve damage, can potentially cause glossopharyngeal neuralgia.
To further determine the cause, magnetic resonance imaging (MRI) of the brain and brainstem helps rule out the causes of glossopharyngeal neuralgia, such as vascular malformation, a tumor, or multiple sclerosis.
A patient may also go to an otolaryngology, or gastroenterology specialist, to rule out other causes.
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GPN Symptoms
Glossopharyngeal neuralgia symptoms include the repetition of acute pain in the areas with connection to the ninth cranial nerve, or the glossopharyngeal nerve. Those areas include the throat, tonsils, tongue, ear, and voice box.
Symptoms include pain that begins in the back of the throat, and goes to the back of the jaw, or to the ear. What’s more, this pain is sometimes so severe that people have trouble speaking, or swallowing.
These painful symptoms are episodic, and may repeat many times throughout the day. In addition, each episode might last a few seconds, or a few minutes. The episodes may also include coughs, and hoarseness of the voice.
It is worth noting, that specific actions that often trigger glossopharyngeal neuralgia, include chewing, coughing, sneezing, swallowing, talking, or yawning.
GPN Diagnosis
The greatest part of the diagnosis for glossopharyngeal neuralgia is clinical. This means that the diagnosis is largely dependent on the patient’s history and symptoms, rather than the results of tests.
In order to determine a diagnosis of glossopharyngeal neuralgia, the doctor will test by touching a cotton swab to the back of the throat. If this causes pain, a local anesthetic (lidocaine) is applied to the back of the throat. If this provides relief, that helps confirm the diagnosis of glossopharyngeal neuralgia.
For a more in-depth diagnosis of the glossopharyngeal neuralgia symptoms, your doctor might order other tests, such as a CT scan, MRI, x-rays, or a blood test, to rule out all other possibilities for the pain.
Interestingly, the purpose of the MRI is to detect tumors, while the CT is to see if the long, pointed bone at the base of the skull is too long, and pressing against the nerve.
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GPN Treatment Options
Glossopharyngeal neuralgia treatment options begin with the goal of treatment to control the pain. While over-the-counter medications are not completely effective, anti-depressants and anti-seizure medications relieve the pain for some people.
Although for only a brief time, local anesthetics might help control the pain. If the tests find an underlying cause, treatment will address the underlying reason for the pain.
An application of lidocaine (a local anesthetic) to the back of the throat not only provides temporary relief, but also assists in confirming a diagnosis.
Sometimes, in extreme cases, surgery is the only recourse to relieve the pain. If the remaining option is surgery, this involves removing the pressure from the glossopharyngeal nerve, or even severing it. During this procedure, the surgeon separates the glossopharyngeal nerve from the artery, and places a small sponge between them. This type of surgery is vascular decompression.
Another type of surgery is rhizotomy, in which the nerve is severed. This is also found, in some instances, to be an effective way to treat glossopharyngeal neuralgia.
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GPN Prognosis
Again, as with the treatment, the prognosis is dependent on the underlying cause of the glossopharyngeal neuralgia. Anti-seizure medications and anti-depressants help some people relieve their pain.
However, if medications are not successful, surgery usually relieves the pain, but might cause numbness or loss of sensation in the mouth, and throat.
Possible Complications of GPM
If you take an anti-depressant or anti-seizure prescription for your symptoms, you may experience side effects from the medication.
Some people experience the pain so intensely that it causes them to faint, and in some instances, their pulse slows down.
More complications occur when there is damage to the carotid artery, or internal jugular artery.
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Conclusion
If you think you have glossopharyngeal neuralgia, call your medical professional immediately. Continue to do your research into the causes of pain in areas of the throat, tonsils, tongue, ear, and voice box. Also, remember that glossopharyngeal neuralgia comes from some type of damage to the ninth cranial or the glossopharyngeal nerve. Additionally, the treatment your doctor selects may be a prescription for either an anti-depressant or an anti-anxiety medication. If those are not effective, usually the next step is to undergo glossopharyngeal neuralgia surgery.
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