Glossopharyngeal Neuralgia

Glossopharyngeal neuralgia (GPN) is both an uncommon and poorly recognized cause of face and neck pain. Because of its potential underdiagnosis, this condition may be more common than reported in the literature. GPN presents with symptoms similar to tic douloureux (trigeminal neuralgia); however, the pathology is not from the trigeminal nerve but rather from the glossopharyngeal nerve. GPN is characterized by unilateral paroxysmal pain in the oropharynx, nasopharynx, larynx, base of the tongue, tonsillar region, and lower jaw, as well as the ipsilateral ear. There are several causes, including tumors, elongated styloid process (Eagle’s syndrome), and vascular compression; however, most cases are considered idiopathic. Treatment for GPN includes treatment of the secondary causes, while medical treatment is similar to that for trigeminal neuralgia. Techniques for cervical, extraoral, intraoral, fluoroscopic, or ultrasound-assisted glossopharyngeal nerve block have been described, and neurolytic techniques such as cryoneuroablation and radiofrequency denervation are available. Because of the location, complications from injections can be serious, and so the injections must be performed with care and knowledge of the anatomy.