Glossopharyngeal (Vagoglossopharyngeal) Neuralgia A Study of 217 Cases

Rushton, Joseph G.; Stevens, Jack; rd, R H Miller

doi:10.1001/archneur.1981.00510040027002

Cited by 292 publications

(222 citation statements)

References 37 publications

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“…29,36,44,54 This incidence is probably underestimated due to insufficient awareness of this condition. Glosso pharyngeal neuralgia is more common on the left side (left:right ratio of 3:2), but TN is more common on the right (right:left ratio 5:3).…”

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confidence: 99%

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Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery

Rey‐Dios

Cohen-Gadol

2013

FOC

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Glossopharyngeal neuralgia (GPN) is an uncommon facial pain syndrome often misdiagnosed as trigeminal neuralgia. The rarity of this condition and its overlap with other cranial nerve hyperactivity syndromes often leads to a significant delay in diagnosis. The surgical procedures with the highest rates of pain relief for GPN are rhizotomy and microvascular decompression (MVD) of cranial nerves IX and X. Neurovascular conflict at the level of the root exit zone of these cranial nerves is believed to be the cause of this pain syndrome in most cases. Vagus nerve rhizotomy is usually reserved for cases in which vascular conflict is not evident. A review of the literature reveals that although the addition of cranial nerve X rhizotomy may improve the chances of long-term pain control, this maneuver also increases the risk of permanent dysphagia and vocal cord paralysis. The risks of this procedure have to be carefully weighed against its benefits. Based on the authors' experience, careful patient selection with a thorough exploratory operation most often leads to identification of the site of vascular conflict, obviating the need for cranial nerve X rhizotomy.

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confidence: 99%

“…Mean follow-up duration was 4.9 years for the MVD group (2 series did not report follow-up time) and 4.7 years for the rhizotomy group (3 series, including Rush ton et al, 54 did not report the length of follow-up). The rate of longterm pain freedom for patients who under went MVD was 84.7% with recurrence in 7% of patients.…”

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Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery

Rey‐Dios

Cohen-Gadol

2013

FOC

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“…As aforementioned, glossopharyngeal neuralgia alone is a relatively uncommon condition 2 , its association with syncope is considered to be very rare 3 , and this paper reports the thirtieth worldwide case of glossopharyngeal neuralgia with syncope secondary to neck cancer and the fi rst Brazilian case of such association. Among the Brazilian cases of classical glossopharyngeal neuralgia previously reported, four were associated with syncope [4][5][6] .…”

Section: Discussionmentioning

confidence: 71%

“…Glossopharyngeal neuralgia was estimated to be 75 times less frequent than trigeminal neuralgia 2 , and its association with syncope was estimated to occur in 1,84% of the cases 3 . Although generally cryptogenic, this condition sometimes have a demonstrable cause, including neoplasms, infections, infl ammations, trauma, elongated styloid process and vascular compression 2 .…”

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Glossopharyngeal neuralgia with syncope as a sign of neck cancer recurrence

Ribeiro

Souza

Carvalho

2007

Arq. Neuro-Psiquiatr.

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-Glossopharyngeal neuralgia with syncope as a sign of neck cancer is a very rare condition. A review of the literature revealed only 29 cases formerly reported. We present the first Brazilian case of such association. A 68-year-old man presented with paroxysmal excruciating pain over the right side of the neck, sometimes followed by syncope. Given the suspicion of recurrent tumor from a previously treated neck malignancy, a computed tomography scan was performed and a right parapharyngeal tumor was shown. Pain and syncope were successfully controlled with carbamazepine and the patient underwent palliative radiotherapy.KEY WORDS: glossopharyngeal neuralgia, syncope, neck cancer, recurrence.Neuralgia glossofaríngea com síncope como um sinal de recidiva de câncer do pescoço RESUMO -Neuralgia glossofaríngea com síncope como um sinal de câncer do pescoço é uma condição muito rara. Uma revisão da literatura revelou apenas 29 casos relatados anteriormente. Apresentamos o primeiro caso brasileiro de tal associação. Um homem de 68 anos se apresentou com dores paroxísticas insuportáveis no lado direito do pescoço, algumas vezes seguidas de síncope. Dada a suspeita de recidiva tumoral derivada de uma malignidade cervical tratada previamente, realizou-se um exame de tomografia computadorizada que evidenciou um tumor parafaríngeo direito. As dores e as síncopes foram controladas satisfatoriamente com carbamazepina e o paciente foi submetido à radioterapia paliativa.PALAVRAS-CHAVE: neuralgia glossofaríngea, síncope, câncer do pescoço, recidiva. Dr. According to the second edition of the International Classifi cation of Headache Disorders 1 , glossopharyngeal neuralgia is a brief severe stabbing pain felt in the ear, base of the tongue, tonsillar fossa or beneath the angle of the jaw. Thus, the pain is located in the distributions of the auricular and pharyngeal branches of the vagus nerve plus of the ipsilateral glossopharyngeal nerve. It is commonly incited by swallowing, talking or coughing and may remit and relapse in the manner of trigeminal neuralgia.Glossopharyngeal neuralgia was estimated to be 75 times less frequent than trigeminal neuralgia 2 , and its association with syncope was estimated to occur in 1,84% of the cases 3 . Although generally cryptogenic, this condition sometimes have a demonstrable cause, including neoplasms, infections, infl ammations, trauma, elongated styloid process and vascular compression 2 . Glossopharyngeal neuralgia with syncope as a sign of neck tumor is a very rare condition. A fairly diligent review of the literature revealed only 29 cases formerly reported (Table). We present the fi rst Brazilian case of such association. CASEA 68-year-old white man with a history of paralaryngeal and pyriform sinus lymphoepithelioma was treated with radical surgery and radiotherapy about 2 years ago. His tumor was stage T3 N2b M0 and he underwent bilateral neck dissection, right hemithyroidectomy, pharyngolaryngectomy with later reconstruction by means of a free microvascular right thigh fl ...

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“…9) Medical treatment with agents such as carbamazepine remains the first choice in patients with GPN, 15) but may gradually become ineffective, so many patients undergo surgery. Microvascular decompression (MVD) achieves good results in patients with a diagnosis of vascular compression syndrome, 7,8,13,14) but a definitive diagnosis is necessary for the selection of MVD surgery as the optimum treatment for GPN.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Balloon Test Occlusion in the Diagnosis of Glossopharyngeal Neuralgia -Case Report-

Hasegawa

Morioka

Kai

et al. 2008

Neurol. Med. Chir.(Tokyo)

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A 67-year-old man presented with glossopharyngeal neuralgia (GPN) manifesting as severe paroxysmal pharyngeal and retroauricular pain not controlled by medical treatment. Constructive interference in steady state magnetic resonance imaging suggested that the responsible vessel was the right vertebral artery (VA). As carbamazepine had some limited effect, we reviewed the appropriateness of microvascular decompression surgery. Balloon test occlusion of the VA was performed to confirm that the GPN was due to right VA pulsation. The neuralgia disappeared and reappeared with balloon inflation and deflation. Therefore, the VA was moved to decompress the glossopharyngeal nerve. The patient was pain-free after surgery. Balloon test occlusion may be useful in the diagnosis of GPN and the selection of the most appropriate surgical treatment.

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Glossopharyngeal (Vagoglossopharyngeal) Neuralgia A Study of 217 Cases

Cited by 292 publications

References 37 publications

Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery

Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery

Glossopharyngeal neuralgia with syncope as a sign of neck cancer recurrence

Usefulness of Balloon Test Occlusion in the Diagnosis of Glossopharyngeal Neuralgia -Case Report-

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