Glossopharyngeal neuralgia is characterized by a sharp, jabbing pain deep in the throat, or in the tongue, ear, and tonsils, lasting a few seconds to a few minutes. The pain is generally caused by a small blood vessel that presses on the nerves as they exit the brainstem. This condition is caused by irritation of the ninth cranial nerve by a blood vessel, and is most commonly seen in people over age 40.
Doctors will typically prescribe treatment with medication before recommending surgery. If surgery is required, UPMC's neurosurgeons may perform Microvascular Decompression.
Your physician will perform a physical exam and will ask about your symptoms.
Symptoms may include severe pain in areas connected to the ninth cranial nerve, which are:
- nasopharynx, or back of the nose and throat
- back of the tongue
- ear
- tonsil area
- larynx or voice box
The pain can be triggered by chewing, coughing, laughing, speaking, or swallowing.
Complications may include:
- Slow pulse and fainting may occur when pain becomes severe.
- Medications used to treat this condition may have side effects.
Doctors usually obtain an MRI scan for patients with these symptoms to rule out tumors or other lesions.
Medications can provide relief to patients with glossopharyngeal neuralgia, but many patients require increasing doses, which can lead to difficult side effects. When this happens, one treatment option at UPMC is Microvascular Decompression.
Microvascular Decompression is a surgical procedure that relieves abnormal compression of a cranial nerve. The surgery consists of a linear incision behind the ear followed by a craniectomy (bony opening) the size of a silver dollar. Under the view of a microscope or endoscope, the surgeons detect the area where the blood vessel is affecting the nerve and then separate them, leaving a Teflon "pillow" in between.
Microvascular Decompression is considered the most effective treatment for this disorder. Despite the rarity of glossopharyngeal neuralgia, UPMC specialists have operated on more than 200 patients, with more than 80 percent reporting immediate and satisfactory results.