NEUROVASCULAR

COMPRESSION

 

 

GLOSSOPHARYNGEAL NEURALGIA

 

 

 

Glossopharyngeal neuralgia (GN) is a pain that occurs in the pharynx, tongue and lingual base and can also reach the external auditory canal in extreme cases. The pain is described as sharp, shooting, lancinating and electrifying. It can sometimes have "destructive" characteristics. The pain can occur spontaneously or at the onset of swallowing, talking, coughing or touching the tongue or throat. Arrhythmia can occur during some pain attacks. Left-sided glossopharyngeal neuralgia can also be conjunct with arterial hypertension.

In rare cases GN is associated with tumors along the nerves or the neck, inflammatory alterations of the nervous system or damage to the nerve itself. In most cases no clear cause can be detected and these are then classified as idiopathic glossopharyngeal neuralgia. In most instances, this form displays a vascular loop at the root entry/exit zone of the cranial nerve IX & X leading to a neurovascular compression. Neurovascular compression can be identified regularly by high resolution MRI.

Carbamazepine, phenytoin and gabapenthine are used for medical treatment. Apart from that, various methods concerning the infiltration of anaesthetics or alcohol at different extra cranial locations along the nerve are performed and mainly result in a partial relief of pain.

Microvascular decompression has resulted into high rates of success with permanent pain relief without loss of function. This method is increasingly being recognized as the best way to treat this entity. Destructive techniques such as severing the nerve are not recommendable.

 

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