Gradual aggravation of idiopathic glossopharyngeal neuralgia due to chronic tonsillitis

Abstract

Rationale:Glossopharyngeal neuralgia (GPN) is a rare type of neuralgia. Depending on the cause, it is classified as idiopathic GPN and secondary GPN. Secondary GPN can also be caused by a mass effect or inflammation of the tonsils, the innervation area of glossopharyngeal nerve.Patient concerns:The patient was diagnosed idiopathic GPN 8 years ago. The patient had intermittent pain, but the pain was well controlled. From 5 months ago, the pain gradually worsened, the patient complained severe pain which impaired chewing and swallowing function.Diagnoses:Idiopathic GPN, secondary GPN, chronic tonsillitisInterventions:Percutaneous glossopharyngeal nerve block, glossopharyngeal neurolysis, and pulsed radiofrequency neuromodulation of glossopharyngeal nerve were performed. After the diagnosis of tonsillitis, antibiotic therapy was performedOutcomes:Two weeks after the antibiotic treatment, the pain decreased simultaneously with the patient's tonsillitis recovery.Lessons:In a Patient who had already been diagnosed with idiopathic GPN, both pain control and its cause should be considered when the pain is aggravated.

Glossopharyngeal Neuralgia and Somatic Tinnitus Caused by a Small Tonsillolith

“…Various surgical procedures including intracranial tumor resection of cerebellopontine angle tumor, posterior fossa decompression of Chiari malformation, carotid stent in carotid megabulb, coagulation of choroid plexus overgrowth, tonsillectomy in chronic tonsillitis or tonsillolithiasis, and stylectomy for Eagle's syndrome can be performed. 3,10,11) In conclusion, small tonsillolith may cause ST and GPN. They can be treated by eliminating tonsillolith and radiofrequency tonsil ablation was good choice of treatment.…”

Curious case of neck pain caused by glossopharyngeal neuralgia

“…[10][11][12] Although most cases of GPN are thought to be idiopathic, in some cases compression of the nerve by a blood vessel (most commonly the posterior inferior cerebellar artery) has been shown to play a role. 3,13,14 Other possible secondary causes of GPN include compression of the nerve by intracranial lesions such as cerebellopontine angle tumour, 15 elongated styloid process (Eagle syndrome), 16 inflammation or scarring of the oropharynx, 17,18 and abnormalities of the cranial base such as Paget disease. 19 To rule out secondary causes of the patient's symptoms, I arranged for unenhanced brain magnetic resonance imaging with thin slices through the brainstem as per radiologist recommendation.…”

A man with tongue pain: A case study

“…Secondary glossopharyngeal neuralgia may also be caused by mechanical compression of the nerve due to anatomic abnormalities, such as elongated styloid processes (stylalgia or Eagle syndrome) or posterior fossa arteriovenous malformation 12,13 . The idiopathic subclassification refers to glossopharyngeal neuralgia without evidence of neurovascular compression or an alternative explanation for glossopharyngeal nerve hyperexcitability 14,15 . It is important to note that all subtypes of glossopharyngeal neuralgia carry an increased risk of bradycardia, syncope, and potentially cardiac arrest given the abnormal input from the glossopharyngeal nerve to the tractus solitarius and the dorsal motor nucleus of the vagus nerve 16 …”

“…12,13 The idiopathic subclassification refers to glossopharyngeal neuralgia without evidence of neurovascular compression or an alternative explanation for glossopharyngeal nerve hyperexcitability. 14,15 It is important to note that all subtypes of glossopharyngeal neuralgia carry an increased risk of bradycardia, syncope, and potentially cardiac arrest given the abnormal input from the glossopharyngeal nerve to the tractus solitarius and the dorsal motor nucleus of the vagus nerve. 16 This abnormal association between the glossopharyngeal afferents and vagal efferent fibers, termed vagoglossopharyngeal neuralgia, can also manifest as vocal hoarseness following pain paroxisms.…”