Glossopharyngeal Neuralgia

What is Glossopharyngeal Neuralgia?

Glossopharyngeal neuralgia syndrome results from the irritation of the 9th cranial or glossopharyngeal nerve resulting in pain of the upper throat and back of the tongue that is accentuated by eating and swallowing (figure 1,2).

The pattern of pain that comes with this syndrome is often mistaken as a dental issue or TMJ. The source of irritation is similar to that of trigeminal neuralgia and hemi-facial spasm and involves pulsation from an intimately apposed cerebral vessel, usually the posterior inferior cerebellar artery. Glossopharyngeal neuralgia is often treated with medications more commonly used for trigeminal neuralgia, with surgery reserved for non-responders. Microvascular decompression has been shown to be efficacious in the majority of cases.

Figure 1
MR image demonstrating the glossopharyngeal/vagus nerve complex (CN IX-X) distorted by overlying posterior inferior cerebellar artery (PICA) with nearby vertebral artery (V)

Intraoperative image demonstrating relationship of PICA to glossopharyngeal nerve (CN IX) in Glossopharyngeal Neuralgia

Figure 2
Intraoperative image demonstrating relationship of PICA to glossopharyngeal nerve (CN IX)

Video illustrates the techniques necessary to safely treat patients with glossopharyngeal neuralgia with microvascular decompression.

Frequently Asked Questions (FAQs) About Glossopharyngeal Neuralgia

What is glossopharyngeal neuralgia?

It is a syndrome caused by irritation of the 9th (glossopharyngeal) cranial nerve, producing pain in the upper throat and the back of the tongue that is made worse by eating and swallowing.

What causes glossopharyngeal neuralgia?

The irritation typically comes from an adjacent, pulsating blood vessel — usually the posterior inferior cerebellar artery (PICA) — pressing on the nerve. This is similar to the cause of trigeminal neuralgia and hemifacial spasm.

How is glossopharyngeal neuralgia treated?

It is often managed with medications also used for trigeminal neuralgia, with surgery reserved for patients who don't respond. Microvascular decompression has been shown to be effective in the majority of cases.

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