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- What Is Glossopharyngeal Neuralgia And How To Treat It?
What Is Glossopharyngeal Neuralgia And How To Treat It?
Not many people have heard of glossopharyngeal neuralgia, but it can be extremely painful for those who suffer with it, which is why diagnosing and treating it quickly is essential.
This rare condition affects the glossopharyngeal nerve in the neck, and is caused by something compressing this nerve, such as a blood vessel, infections or a tumour.
Most people who have GPN develop symptoms over the age of 50, though they can start earlier than this in some cases.
Each episode could be as short as a few seconds or as long as several minutes, and they vary in severity. Some people experience them multiple times a day, though others can go weeks in between occasions.
For most people, these episodes are triggered by an activity that could impact the glossopharyngeal nerve. This includes chewing, coughing, sneezing, yawning, clearing the throat, swallowing, speaking, laughing, or drinking cold beverages.
As time goes on, the symptoms can arise more often, which can have a big impact on patients’ quality of life.
In severe cases, patients might even experience heart irregularities. One in ten people with GPN may have a slow pulse, a sudden drop in blood pressure, seizures or fainting episodes as well, which is caused by the vagus nerve being affected too.
While the symptoms are similar, the areas of the face that are affected differ from GPN.
After consulting a physician, they should schedule blood tests to rule out a tumour or an infection in the area. They will then order a CT scan, MRI and X-Rays of the head to examine what is going on.
<br In cases of GPN, an MRI would show inflammation of the glossopharyngeal nerve through the detailed images. Another way doctors might diagnose a patient is by trying to trigger an episode themselves. They can do this by using a swab on the back of the throat, which could cause a lot of pain if the patient has GPN.
They might then apply local anaesthetic in the back of the throat and swab the area again. If the patient does not experience pain this time, this is an indication they have the condition.
It is also linked with mouth or tonsil infections and the development of cancerous and non-cancerous tumours, as well as blood vessels compressing the nerve.
Anticonvulsant medicines, such as carbamazepine and baclofen, are first used to see if they have an impact on the patient. The doctor might increase the dose or try a different type of anti-seizure tablets to see whether these have better results.
Antidepressants might also be given to patients, as these have been known to help.
If these do not work, the next option is surgery. Microvascular decompression is when pressure is taken off the glossopharyngeal nerve, such as by displacing a blood vessel.
Alternatively, if the nerve is not being compressed, another procedure might occur to cut the glossopharyngeal nerve, which offers relief to patients. Surgeons might also be able to find the cause of the problem and, therefore, have a better idea of how to treat it.
Stereotactic radiosurgery might also be performed, which destroys glossopharyngeal nerve fibres using radiation beams. The energy rays are focused on the nerve root, and the radiation can take a while to take effect, which is why patients often remain on medication in the meantime to manage their pain.
What is glossopharyngeal neuralgia?
Patients with glossopharyngeal neuralgia (GPN) experience bouts of severe pain in their throat, tongue, ears and tonsils, which can last a few minutes at a time.This rare condition affects the glossopharyngeal nerve in the neck, and is caused by something compressing this nerve, such as a blood vessel, infections or a tumour.
Most people who have GPN develop symptoms over the age of 50, though they can start earlier than this in some cases.
What are the symptoms of GPN?
The symptoms of GPN include stabbing pain in the back of the nose and throat, the back of the tongue, the ear, throat, tonsil area or voice box. It is normally concentrated on one side, though it can affect both in rare situations.Each episode could be as short as a few seconds or as long as several minutes, and they vary in severity. Some people experience them multiple times a day, though others can go weeks in between occasions.
For most people, these episodes are triggered by an activity that could impact the glossopharyngeal nerve. This includes chewing, coughing, sneezing, yawning, clearing the throat, swallowing, speaking, laughing, or drinking cold beverages.
As time goes on, the symptoms can arise more often, which can have a big impact on patients’ quality of life.
In severe cases, patients might even experience heart irregularities. One in ten people with GPN may have a slow pulse, a sudden drop in blood pressure, seizures or fainting episodes as well, which is caused by the vagus nerve being affected too.
How is it diagnosed?
It can be hard to diagnose GPN, and the symptoms can be mistaken for trigeminal neuralgia, which is shooting pain in the jaw, cheek, teeth or gums. This is caused when the trigeminal nerve is compressed, due to a blood vessel or tumour.While the symptoms are similar, the areas of the face that are affected differ from GPN.
After consulting a physician, they should schedule blood tests to rule out a tumour or an infection in the area. They will then order a CT scan, MRI and X-Rays of the head to examine what is going on.
<br In cases of GPN, an MRI would show inflammation of the glossopharyngeal nerve through the detailed images. Another way doctors might diagnose a patient is by trying to trigger an episode themselves. They can do this by using a swab on the back of the throat, which could cause a lot of pain if the patient has GPN.
They might then apply local anaesthetic in the back of the throat and swab the area again. If the patient does not experience pain this time, this is an indication they have the condition.
How is it caused?
The underlying causes of GPN might not be known in many cases. However, it is more common in people with demyelinating conditions, such as multiple sclerosis; autoimmune conditions like Sjogren disease; skull or cervical spine malformations; or Eagle syndrome, which involves the stylohyoid ligament.It is also linked with mouth or tonsil infections and the development of cancerous and non-cancerous tumours, as well as blood vessels compressing the nerve.
How can GPN be treated?
The good news for GPN sufferers is that it can be treated through either medications or surgery.Anticonvulsant medicines, such as carbamazepine and baclofen, are first used to see if they have an impact on the patient. The doctor might increase the dose or try a different type of anti-seizure tablets to see whether these have better results.
Antidepressants might also be given to patients, as these have been known to help.
If these do not work, the next option is surgery. Microvascular decompression is when pressure is taken off the glossopharyngeal nerve, such as by displacing a blood vessel.
Alternatively, if the nerve is not being compressed, another procedure might occur to cut the glossopharyngeal nerve, which offers relief to patients. Surgeons might also be able to find the cause of the problem and, therefore, have a better idea of how to treat it.
Stereotactic radiosurgery might also be performed, which destroys glossopharyngeal nerve fibres using radiation beams. The energy rays are focused on the nerve root, and the radiation can take a while to take effect, which is why patients often remain on medication in the meantime to manage their pain.
