What is Glossopharyngeal Neuralgia?
When it comes to identifying types of pain, there are two types: acute and chronic. Acute pain comes on quickly, can be severe but only lasts a relatively short time. It is typically experienced after an injury or trauma, and self-resolves.
Unlike acute pain, chronic pain is pain that lasts for a long time, and doesn't seem to get better or go away. This time period can vary but is typically defined as a three- to six-month period after symptoms begin. Chronic pain is often a debilitating symptom of many diseases and is considered a disease itself when it persists beyond recovery from an injury or illness. Chronic pain is a frequent component of many neurological disorders.
Pain warns you that something is not quite right in your body and can cause you to take certain actions and avoid others. Pain can significantly affect your quality of life—by adversely affecting your physical and emotional well-being; upsetting relationships with family, coworkers and friends; and limiting your mobility and participation in daily activities.
Hundreds of pain syndromes or disorders make up the spectrum of pain. One cause of pain are cranial neuralgias (CNs), which are syndromes caused by disruption or damage to the nervous system including the peripheral nerves, spinal cord and brain. These conditions cause sudden attacks of stabbing, sharp, pain around the face and head called paroxysms. There are three common types of CNs: trigeminal neuralgia, glossopharyngeal neuralgia and hemifacial spasm.
Following trigeminal neuralgia, the second most common type of cranial neuralgias is glossopharyngeal neuralgia, a rare facial pain condition characterized by brief but sharp or stabbing painful episodes in the tongue, throat, ear and tonsils. These episodes can occur within minutes of each other and then stop entirely for days at a time. Glossopharyngeal neuralgia is believed to be caused by irritation of the ninth cranial nerve.
Types of Glossopharyngeal Neuralgia
Cranial neuralgias (CN) are syndromes caused by disruption or damage to the nervous system including the peripheral nerves, spinal cord and brain. These conditions cause sudden attacks of stabbing, sharp, pain around the face and head called paroxysms. There are three common types of CNs: trigeminal neuralgia, glossopharyngeal neuralgia and hemifacial spasm.
Causes of Glossopharyngeal Neuralgia
The most common cause of glossopharyngeal neuralgia (GN) is vascular compression mainly at the nerve root. Additional causes include demyelinating diseases: (such as multiple sclerosis), inflammatory and autoimmune diseases (like Sjögren’s disease), intraoral and peritonsillar infections, tumors, cervical malformations and oropharyngeal cancers include carcinoma of the tongue and benign tumors (like schwannomas).
Pain episodes are commonly triggered by coughing, talking and swallowing. Pain in glossopharyngeal neuralgia follows a relapsing and remitting pattern.
Risk Factors For Glossopharyngeal Neuralgia
Glossopharyngeal neuralgia (GPN) typically occurs in individuals who are 50 years old and older. Manifestations of GPN increase with age; therefore, age is the primary risk factor for developing GPN.
Additionally, in some cases of GPN, patients are found to have cardiovascular or neurological symptoms such as asystole, bradycardia, hypotension, syncope, seizures or even cardiac arrest. These symptoms result from overlapping connections with the vagus nerve (the main nerve in the parasympathetic nerve system that controls digestion, heart rate and nervous system).
Screening For & Preventing Glossopharyngeal Neuralgia
If you suspect you may have glossopharyngeal neuralgia GPN, work with your physician to have a swab test performed. Using a cotton-tipped applicator, your healthcare professional will lightly touch the back of your throat to trigger pain. By then applying a local anesthetic to the area, the doctor will determine whether pain is relieved—if so, a diagnosis of GPN is likely.
Signs & Symptoms of Glossopharyngeal Neuralgia
Those with glossopharyngeal neuralgia will experience a jabbing and sharp pain in the ear, tonsils, tongue or throat that lasts anywhere from a few seconds to a few minutes. Symptoms typically affect one side of the throat and may be experienced for several days up to a few weeks. Up to 10 percent of patients may experience heart irregularities including seizures, fainting, slow pulse and sudden drop in blood pressure.
Diagnosing Cranial Neuralgias
If you suspect you may have GPN, work with your physician to have a swab test performed. Using a cotton-tipped applicator, your healthcare professional will lightly touch the back of your throat to trigger pain. By then applying a local anesthetic to the area, the doctor will determine whether pain is relieved—if so, a diagnosis of GPN is likely.
Treating Glossopharyngeal Neuralgia
Patients with glossopharyngeal neuralgia are predisposed to lose weight from the severe pain associated with chewing and swallowing. Attacks of pain surprisingly subside on their own most of the time, but unpleasant sensations may remain for several weeks to months in the affected areas. Treatment using neuropathic pain medicines (such as gabapentin, duloxetine, valproic acid, clonazepam, etc.) is typically effective. Additionally, home remedies that are effective include cold and hot compresses, physical therapy and counseling.
Living with Glossopharyngeal Neuralgia
Episodes of pain can last from a few seconds to a few minutes, and often stop on their own. Many diagnosed with GN will live free of long-term pain with treatment. Pain management may include prescriptions to anticonvulsant medications like carbamazepine (Tegretol), gabapentin (Neurontin), phenytoin (Dilantin), pregabalin (Lyrica), oxcarbazepine (Trileptal) and baclofen (Lioresal).