Syncopal storm caused by glossopharyngeal neuralgia

Kazemi, Babak; Akbarzadeh, Fariborz

doi:10.1016/j.ajem.2012.03.003

Cited by 10 publications

(10 citation statements)

References 17 publications

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“…Two mechanisms have been postulated to cause syncope in cases of neck carcinoma (4,8). First, the tumor directly stimulates the peripheral branches of the glossopharyngeal nerve.…”

Section: Discussionmentioning

confidence: 99%

“…Afferent glossopharyngeal stimulation proceeds to the brainstem centers in the caudal nucleus of the solitary tract. Interneurons then activate the efferent fibers, resulting in stimulation of the parasympathetic systems, leading to bradycardia (4,8). Second, afferent glossopharyngeal stimulation proceeds to brainstem centers in the spinal nucleus of trigeminus.…”

Section: Discussionmentioning

confidence: 99%

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Glossopharyngeal Neuralgia with Syncope Caused by Recurrence of Esophageal Squamous Cell Carcinoma

Nagata

Tajiri

Ueda³

et al. 2019

Intern. Med.

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We herein report a case of glossopharyngeal neuralgia with repeated syncope caused by the recurrence of esophageal carcinoma. The typical symptoms of glossopharyngeal neuralgia are paroxysmal, stabbing, electric shock-like pain in the pharynx and/or base of the tongue on swallowing and talking. In addition, syncope can also be caused by glossopharyngeal neuralgia. The diagnosis of glossopharyngeal neuralgia is not always easy because of its rarity. In the present case, we suspected that repeated syncope was caused by glossopharyngeal neuralgia due to the recurrence of esophageal carcinoma. Concurrent chemoradiation therapy was effective in reducing the tumor size, which resulted in the complete resolution of the symptoms.

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“…Two mechanisms have been postulated to cause syncope in cases of neck carcinoma (4,8). First, the tumor directly stimulates the peripheral branches of the glossopharyngeal nerve.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Glossopharyngeal Neuralgia with Syncope Caused by Recurrence of Esophageal Squamous Cell Carcinoma

Nagata

Tajiri

Ueda³

et al. 2019

Intern. Med.

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“…In some reports [17,18] treatment with carbamazepine abolished the pain and associated cardiovascular manifestations. However, in other cases, treatment with carbamazepine alone [19,20], carbamazepine and gabapentin combination [21] or clonazepam [22] was not sufficient to alleviate the pain and syncopal episodes in GPN, necessitating the insertion of a permanent pacemaker to prevent syncope. Other successful treatments of refractory cases included section of the ninth (glossopharyngeal) nerve alone [23,24], or combined with rhizotomy and microvascular decompression of the lower cranial nerves [25].…”

Section: Discussionmentioning

confidence: 99%

A Bone-Breaking Case of Syncope Due to Glossopharyngeal Neuralgia

Austin

2014

J Med Cases

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Glossopharyngeal neuralgia is an uncommon cause of intense facial pain, and is rarely associated with syncope. We present a patient with malignant syncope precipitated by glossopharyngeal neuralgia (GPN), who sustained lower extremity fractures. A 64-year-old Caucasian female with hypertension, diabetes mellitus type 2 and dyslipidemia, presented to the emergency department (ED) after a witnessed syncopal event. Over the preceding 9 months, she experienced multiple syncopal episodes triggered by neck pain, and was diagnosed with GPN by an ENT specialist. She reported a severe, stabbing pain in the right side of her neck prior to the event. Her vital signs and physical examination were unremarkable, except for bilateral leg tenderness. Laboratory data were within normal limits. Electrocardiogram revealed normal sinus rhythm, a rate of 72 beats per minute (BPM), and otherwise normal. Lower extremity X-rays revealed bilateral non-displaced fibular fractures. In the ED, she sustained another syncopal event, and bradycardia with transient heart rates as low as 22 BPM were documented. A temporary transvenous pacemaker was placed. She required pacing repeatedly for repeated bradycardic episodes preceded by right-sided neck pain. She was started on carbamazepine, without complete resolution of her symptoms on escalating doses. Due to recurrent bradycardia with frequent neck pains, requiring temporary pacing, an MRIcompatible permanent pacemaker was placed, to allow for further MRI recommended by neurology service. At 8-week follow-up, she had fully recovered from her neuralgic pain and fractures, without further syncope. This case emphasizes the potentially serious morbidity of GPN-induced syncope and importance of a prompt clinical diagnosis and treatment.

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“…GN occurs with a frequency of about 1% that of trigeminal neuralgia but has very similar pain characteristics as well as adjacent locations of pain and similar triggers 3. GN occurs more frequently on the left, while trigeminal neuralgia occurs more commonly on the right 4.…”

Section: Differential Diagnosismentioning

confidence: 99%

Glossopharyngeal neuralgia associated with cardiac syncope

2016

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Glossopharyngeal neuralgia is a rare pain syndrome presenting with paroxysms of pain in the region of the glossopharyngeal nerve. Even more uncommon is the association between glossopharyngeal neuralgia and cardiac syncope. In these patients, the cardiovascular consequences may include bradycardia, hypotension and cardiac arrest. We describe the case of a 40-year-old patient who presented with this rare association of glossopharyngeal neuralgia and syncope. Multiple pauses including one lasting 14 s were noted on ambulatory ECG monitoring. In this case, the patient declined pharmacological treatment with carbamazepine or with permanent pacing and so far has been in remission from symptoms for 3 months.

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Syncopal storm caused by glossopharyngeal neuralgia

Cited by 10 publications

References 17 publications

Glossopharyngeal Neuralgia with Syncope Caused by Recurrence of Esophageal Squamous Cell Carcinoma

Glossopharyngeal Neuralgia with Syncope Caused by Recurrence of Esophageal Squamous Cell Carcinoma

A Bone-Breaking Case of Syncope Due to Glossopharyngeal Neuralgia

Glossopharyngeal neuralgia associated with cardiac syncope

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