Glossopharyngeal Neuralgia

FACTS

  • can be idiopathic vs. compressive
Vessel
Nerve
Compressive Syndrome
Notes
SCA
CN 5
Trigeminal Neuralgia
AICA
CN 7
Hemi-fascial Spasm
PICA
CN 12
Glossopharyngeal Neuralgia
swallowing, talking, chewing triggers the attacks

HPI

  • severe, intermittent, and lancinating pain
  • does pain radiate to ear? (distinguish from geniculate neuralgia)

    PHYSICAL EXAM

    • diminished sensation over pharynx
    • ipsilateral gag reflex reduction
    • absence of taste on posterior 1/3 of tongue

    IMAGING

     
    A/P
    Diagnostic: pain relief with application of cocaine
    Operative strategy:
    • compressive: separate PICA from CN9
    • idiopathic: divide CN9 and upper 1/3 of vagus nerve