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KMID : 0614720230660010019
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Journal of Korean Medical Association
2023 Volume.66 No. 1 p.19 ~ p.30
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Diagnosis and treatment of glossopharyngeal neuralgia
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Ahn Young-Hwan
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Abstract
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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.
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KEYWORD
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Glossopharyngeal neuralgia, Microvascular decompression surgery, Trigeminal neuralgia
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