Definition Glossopharyngeal neuralgia is a condition that causes sudden bouts of pain in the throat and the back of the mouth and tongue.
What is going on in the body? Neuralgia is a term that means nerve pain, or pain caused by a nerve problem. The nerve that attaches to the throat and the back of the tongue and mouth is called the glossopharyngeal nerve. Sometimes a problem in this nerve can cause pain in these areas. The pain can be severe and usually lasts from a few seconds to a few minutes. Swallowing, coughing or sneezing usually bring on an attack of the pain.
What are the signs and symptoms of the condition? The main symptom of glossopharyngeal neuralgia is pain, which can be severe. The pain usually lasts only seconds, but it may go on for a few minutes. In severe cases, the attacks of pain can occur many times during the day. The pain is usually in the throat and the back of the mouth and tongue. In some cases, the pain may spread to the jaw or ear. In rare cases, a person may even faint. The pain is usually triggered by normal activities, such as swallowing, coughing, or sneezing.
What are the causes and risks of the condition? The cause of glossopharyngeal neuralgia is unknown. The diagnosis is usually made when no other cause for the pain or nerve problem can be found. People more than 40 years old are most commonly affected. This condition is more common in men than in women.
What can be done to prevent the condition? There is no known way to prevent this glossopharyngeal neuralgia.
How is the condition diagnosed? Diagnosis of glossopharyngeal neuralgia begins with a history of the attacks and a physical examination. The doctor may try to bring on an attack by touching the back of the throat or asking the person to cough or swallow. A local anaesthetic can then be sprayed in the back of the throat, which usually stops the attack.
It is important to make sure there is not a more serious cause for the symptoms. A CT scan or MRI may be done to rule out a more serious cause, such as a tumour or stroke.
What are the long-term effects of the condition? In severe cases, the pain of glossopharyngeal neuralgia can be bad enough to keep a person from his or her normal activities. Those who faint from this condition may injure themselves.
What are the risks to others? Glossopharyngeal neuralgia is not contagious and poses no risks to others.
What are the treatments for the condition? Medications that are used to treat seizures, such as carbamazepine, are often used to control the pain. If medications cannot control the pain, the person may need to have surgery. Surgery can involve either moving blood vessels and other tissue that surround the nerve, or cutting or removing parts of the nerve.
What are the side effects of the treatments? Carbamazepine and other anti-seizure medications can cause dizziness, allergic reactions, and stomach upset. Surgery often reduces sensation to the throat, the back of the mouth, and the tongue. Infections and swallowing problems may also occur.
What happens after treatment for the condition? It is hard to predict the course of glossopharyngeal neuralgia. Some people may not have any more pain after treatment, while others may continue to have bouts of pain. Different medications and surgeries can be tried if certain treatments fail to solve the problem.
How is the condition monitored? Any change in symptoms or response to treatment should be reported to the doctor. Blood tests may be needed to monitor the medications used to treat glossopharyngeal neuralgia.
Author: James Broomfield, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 25/05/2005 Contributors Potential conflict of interest information for reviewers available on request
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