Glossopharyngeal Neuralgia is a condition causing severe pain in the deep throat, tonsil, or deep ear areas. Pains are sharp, severe, brief, and episodic. People often say that the pains feel like electric shocks, and they can be triggered by swallowing, coughing, and sensations in the deep ear. Some patients may experience spontaneous remissions, where the pains go away for weeks, months, or even years. Others require treatment.
With Glossopharyngeal Neuralgia, sporadic and excruciating pain generally begins in the back of the mouth and the throat, and shoots toward the ear. The sharp pains may affect areas along the path of the ninth cranial nerve:
Since the tenth cranial nerve transports sensory information to and from the voice box, a deep neck pain could indicate damage to one of the vagus nerves.
Various everyday activities can trigger the intense pain:
Atypical glossopharyngeal neuralgia presents nonconforming pain symptoms such as a blunted or burning ache in the same region.
Causes of Glossopharyngeal Neuralgia can generally be categorized two ways:
Compression of the ninth and possibly tenth cranial nerve by a blood vessel.
Much less often, multiple sclerosis, an infection or a tumor places pressure on the nerve.
Along with learning your medical history and performing a physical, your neurospecialist may ask for other tests.
Any infections or disease (multiple sclerosis or diabetes) that can damage the myelin sheath (covering of the nerve) could also contribute to neuralgia. A blood test can show extreme glucose levels that could be harming the myelin sheath.
An MRI may show if a blood vessel is in contact with the glossopharyngeal nerve. CT (computer tomography) scans create a picture using cross-sectional images of your head and neck. A CT angiogram (x-ray taken using angiography) focuses on the blood or lymph vessels that could be contributing to your head or neck pain.
Glossopharyngeal Neuralgia treatments can include medications and surgical procedures.
Anticonvulsant medicines may reduce or relieve the pain symptoms.
Microvascular Decompression Surgery (MVD) involves one of our premier neurosurgeons entering the skull behind the ear and lifting the offending blood vessel away from the impacted nerve thus relieving the pressure and removing the cause of the pain.
During Stereotactic Radiosurgery, one of our board-certified neurosurgeons who specializes in using the Gamma Knife machine pinpoints a radiation beam to injure part of the glossopharyngeal nerve root. This radiosurgery is less invasive than MVD, no incision is required and patients are often discharged the same day.
The expert neurospecialists at NSPC provide exemplary diagnosis and treatments for glossopharyngeal neuralgia. Located on Long Island and the New York area, our award-winning medical centers provide innovative approaches for your brain or spine condition.
Glossopharyngeal neuralgia treatment may involve a very effective, low-risk operation under general anesthesia. We make a small incision behind the ear, remove a small amount of skull bone, and explore the 9th and 10th cranial nerves using a microscope. From there, we may move the blood vessel away from the nerve, if needed, and insert a sponge between the blood vessel and nerve. If we do not find a blood vessel, then we will usually cut the 9th nerve and the upper fibers of the 10th nerve.
We may also choose to injure the nerve using a super-focused radiation procedure or Gamma Knife Stereotactic Radiosurgery. This is an out-patient procedure that involves radiation on the 9th and 10th cranial nerve roots. This nerve injury procedure is less invasive, although patients may still need to use some medication for ongoing pain relief after the procedure.
We used to perform a different type of nerve injury involving insertion of a needle through the cheek and threading it through the nerve. However, it was difficult to selectively injure the sensory portion of the 10th nerve, and not the motor portion, which is important for maintaining swallowing and vocal function.
In summary, there are several effective glossopharyngeal neuralgia treatments, including the open procedure and the Gamma Knife procedure.
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