What is Glossopharyngeal Neuralgia?

Glossopharyngeal neuralgia is a rare neurological disorder that can cause repeated episodes of severe pain in the head, including the throat, ears, tongue and tonsils. While it is thought to be caused by irritation of the glossopharyngeal nerve —the ninth cranial nerve — researchers aren’t entirely sure why the irritation occurs.

While a definitive cause for the irritation is unknown, there is some thought that glossopharyngeal neuralgia could result from:

• Blood vessels putting pressure on the glossopharyngeal nerve
• Growths at the base of the skull pressing on the nerve
• Infections of the throat or mouth causing pressure on the nerve
• Tumors putting pressure on the glossopharyngeal nerve

The current understanding is that when pressure is applied to the glossopharyngeal nerve, glossopharyngeal neuralgia is the result, leading to intense nerve pain in the region affected by the nerve.

This type of neuralgia typically exhibits in brief episodes, lasting anywhere from a few seconds to a few minutes. These episodes can be triggered by movements of the head, such as when swallowing, coughing, sneezing or talking, or by drinking something cold.

Symptoms of Glossopharyngeal Neuralgia

When the glossopharyngeal nerve is functioning normally, it controls the muscles in the throat and sends information from the tonsils, throat and tongue to the brain. So, when this nerve is adversely affected, the resulting neuralgia impacts those same body parts.

In a glossopharyngeal neuralgia episode, pain typically begins at the back of the throat or tongue and may spread into the ears or jaw. An episode is typically described as an intense stabbing or burning pain, usually affecting only one side of the head. Other symptoms may include:

• Difficulty speaking or swallowing
• Fainting
• Low blood pressure
• Slowed heart rate

How Glossopharyngeal Neuralgia Is Diagnosed

If a doctor suspects glossopharyngeal neuralgia, he or she will perform a simple test. Using a cotton swab, the doctor will touch the back of the throat. If glossopharyngeal neuralgia is present, this will typically cause a pain episode, but this will be quickly relieved using an anesthetic. If pain results from the application of the swab and stops when the anesthetic is applied, glossopharyngeal neuralgia is the likely cause. This test is used to differentiate the condition from trigeminal neuralgia, which causes similar pain flare-ups.

If a diagnosis of glossopharyngeal neuralgia is confirmed, further testing may be recommended to determine a potential cause for the neuralgia. This may include an MRI to look for tumors, CT scan to visualize the head area and/or angiography to examine the arteries.

Treatment for Glossopharyngeal Neuralgia

The goal of treatment for glossopharyngeal neuralgia is to alleviate pain during neuralgia flare-ups. In most cases, over-the-counter pain medications is ineffective at relieving this pain. A doctor may recommend the application of a local anesthetic to the back of the throat for temporary relief. However, this method only helps for a short time.

Anti-seizure medications and antidepressants have also been shown as effective in managing glossopharyngeal neuralgia in some patients.

Another option is to treat the condition with surgery. During a surgical procedure called microvascular decompression, a doctor will relieve pressure on the glossopharyngeal nerve by either removing the source of the pressure or severing the nerve so that it no longer transmits pain signals.