J Korean Med Assoc.  2023 Jan;66(1):19-30. 10.5124/jkma.2023.66.1.19.

Diagnosis and treatment of glossopharyngeal neuralgia

• Ahn YH

• KMID: 2539076
• DOI: http://doi.org/10.5124/jkma.2023.66.1.19

Abstract

Background
Glossopharyngeal neuralgia (GPN) is a rare type of cranial nerve rhizopathy that accounts for roughly 1% of trigeminal neuralgia cases and presents as extreme neuralgic pain in the ipsilateral deep throat, tongue base, or ear. Pain is usually intense and electric shock-like, occurring either without warning or triggered by swallowing. The purpose of this article is to provide a comprehensive review of the diagnosis and treatment of GPN and to differentiate it from trigeminal neuralgia.
Current Concepts
In this review, our experiences, including cases of misdiagnosis and diagnostic pitfalls, are presented in detail. Treatment of GPN with microvascular decompression (MVD) has a success rate of over 90%. The use of “off-the-root entry zone” MVD, which eliminates the need for an adjuvant rhizotomy, is the best treatment for GPN. In addition, although gamma knife radiosurgery is categorized as a destructive procedure, it can still be another option if a patient is ineligible for MVD.
Discussion and Conclusion
Practitioners must consider GPN when diagnosing patients with cranial nerve rhizopathy; it should be distinguished from other pain syndromes, especially trigeminal neuralgia. With an accurate diagnosis, an appropriate treatment plan can be developed.

Keyword

Glossopharyngeal neuralgia; Microvascular decompression surgery; Trigeminal neuralgia; 혀인두신경통; 미세혈관수술; 삼차신경통