Glossopharyngeal Neuralgia

Excerpt

Glossopharyngeal neuralgia (GN) is a rare pain syndrome in the sensory distribution of the ninth cranial nerve, also known as the glossopharyngeal nerve. As per ICHD-3 (International Classification of Headache Disease- 3) classification, glossopharyngeal neuralgia is a disorder characterized by a brief episodic unilateral pain, with sharp and stabbing in character, with abrupt onset and cessation, in the glossopharyngeal nerve distribution (angle of the jaw, ear, tonsillar fossa and the tongue base). It also involves the pharyngeal and auricular branches of CN X. Pain is commonly triggered by coughing, talking, and swallowing. Pain in glossopharyngeal neuralgia follows a relapsing and remitting pattern. It falls under the International Classification of Diseases (ICD) category as ICD-10-CM-G52.1.

In 1910, T. Weisenburg was the first to describe the symptoms of glossopharyngeal neuralgia in a 35-year-old male with compression of the ninth cranial nerve by a tumor at the cerebellopontine (CP) angle. W. Harris was the first physician to label these symptoms as “glossopharyngeal neuralgia” in 1921, based on his observation of two of his patients. In 1927, there were two significant developments in the understanding and treatment of glossopharyngeal neuralgia. These included a published case series of 18 patients by J. Doyle and the first successful intracranial resection for glossopharyngeal neuralgia performed by W. Dandy.

Riley et al. in 1942 noted that occasionally the painful attacks of glossopharyngeal neuralgia were associated with syncopal episodes, transient or persistent bradycardia, asystole, and even seizures. When these features correlate with glossopharyngeal neuralgia, the term for this condition is vagoglossopharyngeal neuralgia. Glossopharyngeal neuralgia often gets misdiagnosed as trigeminal neuralgia since pain characteristics are very similar in both entities.