Glossopharyngeal neuralgia as the name implies is a type of neuralgia and this neuralgia involves the 9th cranial nerve which is also called as glossopharyngeal nerve. Neuralgia is the term used for irritation of any nerve along with the symptoms produced by such irritated nerve, especially the annoying pain it commonly causes. So the above term means the annoying pain produced by the irritation of the 9th cranial nerve or glossopharyngeal nerve.
What causes this condition?
Sometimes there is no obviously identifiable cause for this neuralgia condition of the glossopharyngeal nerve and this type of neuralgia is called as idiopathic and this medical term means the cause is not found. In fact most of the neuralgia involving the 9th cranial nerve are idiopahtic because even after extensive investigations many times no cause is found. If a cause is found then it is called as secondary neuralgia because the nerve irritation is due to some identifiable cause. And such secondary causes include any structural problems in or around the brainstem where the 9th cranial nerve originates or along the path of this nerve, and examples of such structural causes include abnormaly placed blood vessels, tumors, MS, stroke, granulomas etc.
How does the patient present?
Patients with glossopharyngeal neuralgia will present with severe short duration pain in the throat area. This pain may be triggered by eating or drinking. Several attacks of severe pain may occur in the same day. There may be atypical presentations too. Rarely the attacks of pain may also be associated with heart related symptoms since there is some connection with the nerve supplying the heart (the vagus nerve) and the glossopharyngeal nerve.
How this condition is diagnosed?
Once a clinical diagnosis is made then the patient will need to undergo an MRI scan of the brain with and without contrast agent. The MRI of the brain will help in ruling out any secondary cause for the neuralgia. Sometimes an angiogram study may also be required and this study will specifically look for any abnormally positioned artery compressing the glossopharyngeal nerve near the brain stem area.
If the investigations reveal any secondary cause for this neuralgia then it is treated appropriately. For the pain management there are various nerve pain pills and if the medications fail to relieve the pain adequately then there are various surgical options too.
A neurologist is commonly involved in the management of glossopharyngeal neuralgia.
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