Glossopharyngeal neuralgia is a condition that causes sudden bouts of pain in the throat and the back of the mouth and tongue.
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 or 9th cranial 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.
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.
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.
There is no known way to prevent this glossopharyngeal neuralgia.
Diagnosis of glossopharyngeal neuralgia begins with a history of the attacks and a physical exam. The healthcare professional may try to bring on an attack by touching the back of the throat or asking the person to cough or swallow.
A local anesthetic 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 tumor or stroke.
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.
Glossopharyngeal neuralgia is not contagious and poses no risks to others.
Medications that are used to treat seizures, such as carbamazepine (i.e., Carbatrol, Equetro, Tegretol) with or without phenytoin (i.e., Dilantin, Phenytek), 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.
Carbamazepine, phenytoin and other antiseizure 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.
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.
Any change in symptoms or response to treatment should be reported to the healthcare professional. Blood tests may be needed to monitor the medications used to treat glossopharyngeal neuralgia.
The Merck Manual, 1995, Berkow et al.