Glossopharyngeal Neuralgia

Abstract

Glossopharyngeal neuralgia (GPN) is a pain syndrome characterized by attacks of severe pain in the sensory distribution of the glossopharyngeal nerve. Most cases of GPN respond to treatment with carbamazepine and other anticonvulsants. The causative element of essential GPN appears to be a vascular compression of the glossopharyngeal nerve root and the upper rootlets of the vagus nerve; therefore, the most definitive surgical treatment consists of microvascular decompression of the ninth (and tenth) nerve in the posterior cranial fossa. In cases of secondary GPN and when microvascular decompression is not possible, intracranial rhizotomy of the glossopharyngeal and upper portion of the vagal nerve roots may be the next logical step in surgical management. Extracranial neurotomy and percutaneous radiofrequency rhizotomy are useful for patients with GPN who have failed medical treatment but for some reason cannot undergo intracranial intervention.