Glossopharyngeal neuralgia of tumor origin diagnosed in dental care. Case report

BACKGROUND AND OBJECTIVES: The glossopharyngeal neuralgia is a neuropathy considered rare that manifests itself in the IX cranial nerve distribution characterized by an electric shock-like pain, often associated with hyperalgesia and allodynia. The etiology may be related to vascular changes, brain tumor, or even idiopathic. The aim of this study was to report a case of glossopharyngeal neuralgia secondary to a brain tumor diagnosed in a dental clinic, highlighting its clinical manifestations and discussing its nosological limit with other orofacial pain. CASE REPORT: Female patient, 63 years old, sought care at a dental outpatient clinic of Orofacial Pain complaining about an intense electric shock and jumping pain of sudden onset on the lower right edge region and right tongue base. She reported that the events were triggered and exacerbated when chewing, opening the mouth, laughing and talking. The diagnostic hypothesis of glossopharyngeal neuralgia was tested by momentary depletion to the application of benzocaine 20% and pain remission with the administration of carbamazepine (400mg/ day) for 20 days. The patient was referred to the Neurology service of the hospital, where the magnetic resonance imaging presented an expansive, solid, extra-axial lesion in the right prepontine cistern, suggesting meningioma. CONCLUSION: The professional should be aware of the differential diagnosis of orofacial pains, especially in episodic neuropathies, to rule out the tumor etiology. In these cases, the quick referral to tertiary centers is fundamental for the good prognosis.