OverviewGlossopharyngeal neuralgia is extreme pain in the back of the throat, tongue or ear. Attacks of intense, electric shock-like pain can occur without warning or can be triggered by swallowing. Although the exact cause is not known, a blood vessel is often found compressing the nerve inside the skull. It can also occur in people with throat or neck cancer. Medications may initially relieve the pain, but surgery is often needed for long-term relief. Show
What is glossopharyngeal neuralgia?Neuralgia is severe pain caused by injury or damage to a nerve. The glossopharyngeal nerve is the ninth (IX) cranial nerve, which arises from the brainstem inside the skull. It supplies sensation to the back of the throat and tongue and portions of the ear (Fig. 1). When the glossopharyngeal nerve becomes irritated, an attack of intense electric shock-like pain is felt in the back of the throat, tongue, tonsil or ear. You may initially experience short, mild attacks, with periods of remission. But neuralgia can progress, causing longer, frequent attacks of searing pain. Figure 1. The glossopharyngeal nerve begins in the brainstem and exits the skull at the jugular foramen. It sends branches to the back of the tongue, throat, tonsil, ear, and carotid body.Glossopharyngeal pain can be similar to trigeminal neuralgia – and misdiagnosed. Be sure to see a neurosurgeon who specializes in facial pain who can make the distinction. What are the symptoms?Patients describe an attack as a burning or jabbing pain, or as an electrical shock that may last a few seconds or minutes. Swallowing, chewing, talking, coughing, yawning or laughing can trigger an attack. Some people describe the feeling of a sharp object lodged in the throat. The pain usually has the following features: The pain usually has the following features:
About 10% of patients also have potentially life-threatening episodes of heart irregularities caused by involvement of the nearby vagus nerve, such as:
What are the causes?Many believe that the protective sheath of the nerve deteriorates, sending abnormal messages. Like static in a telephone line, these abnormalities disrupt the normal signal of the nerve and cause pain. Most often the damage is from a blood vessel compressing the nerve. Other causes include aging, multiple sclerosis, and nearby tumors. Who is affected?Glossopharyngeal neuralgia is rare compared to other facial pain syndromes. It occurs slightly more in women than men; usually middle age and older. How is a diagnosis made?When a person first experiences throat pain, a primary care doctor or dentist is often consulted. If the pain requires further evaluation, a neurologist or a neurosurgeon may be recommended. The diagnosis of neuralgia is made after carefully assessing the patient's symptoms. If glossopharyngeal neuralgia is suspected, the doctor will attempt to trigger an episode by touching the back of the throat with a swab. If that causes pain, a topical anesthetic is applied to the back of the throat and the doctor will try the pain stimulus again. If pain is not triggered while the area is numb, glossopharyngeal neuralgia is diagnosed. Other tests may include an MRI or MRA to look for tumors or a blood vessel compressing the nerve. What treatments are available?A variety of treatments are available, including medication, surgery, needle procedures, and radiation. First-line treatment is usually medication. When medications fail to control pain or cause intolerable side effects, a neurosurgeon may be consulted to discuss other procedures. Medication
Surgery
Figure 2 (left). During MVD, a craniotomy is made in the skull. The glossopharyngeal nerve is often compressed by an artery. Lying close by is the vagus nerve.Figure 3 (right). A sponge is inserted between the nerve and the blood vessel to relieve the compression that causes the painful neuralgia attacks. Needle procedures
Radiation
Clinical trialsClinical trials are research studies in which new treatments—drugs, diagnostics, procedures, and other therapies—are tested in people to see if they are safe and effective. Research is always being conducted to improve the standard of medical care. Information about current clinical trials, including eligibility, protocol, and locations, are found on the Web. Studies can be sponsored by the National Institutes of Health (see Clinicaltrials.gov) as well as private industry and pharmaceutical companies (see Centerwatch.com). RecoveryNo single procedure is best for everyone and each procedure varies in its effectiveness versus side effects. Sources & linksIf you have more questions, contact Mayfield Brain & Spine at 800-325-7787 or 513-221-1100.
Glossaryanticonvulsant: a drug that stops or prevents convulsions or seizures. neuralgia:
nerve pain. neurectomy: cutting of a nerve to relieve pain. percutaneous: through the skin. radiofrequency: radiant energy of a certain frequency. rhizotomy: interruption or destruction of a group of nerve fibers by chemical or radiowaves. updated > 7.2018 Why does one side of my throat hurt when I move my tongue?Tonsillitis
There are two tonsils, one on each side of your throat. Sometimes, only a single tonsil is affected by tonsillitis, causing a sore throat on one side. The primary cause of viral infection is tonsillitis, but they can also occur due to bacterial infections.
Why does my tongue hurt on the side?A sore on the side of the tongue can develop for a wide variety of reasons. Often, mouth sores are not a sign of a serious condition. They may be canker sores, cold sores, or the result of a minor injury. In some cases, severe, recurring, or persistent mouth sores can be a symptom of an underlying condition.
What do you do when your throat and tongue hurt?Salt water. Gargling salt water is another way to reduce pain, inflammation, and prevent infection. Mix a teaspoon of salt in a cup of warm water, swish it around your mouth, gargle, and spit.
Can your tongue hurt with a sore throat?A sore throat, also called a throat infection or pharyngitis, is a painful inflammation of the back part of the throat (pharynx). Pharyngitis can involve some or all of these parts of the throat: the back third of the tongue. the soft palate (roof of the mouth)
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