Glossopharyngeal neuralgia: Nerve pain in the face

Glossopharyngeal neuralgia causes damage to the ninth cranial nerve. This causes patients to experience extreme pain in the back of the throat, tongue and ear. Although the exact cause is not known, but usually a blood vessel is present that causes damage to the nerve. Medications usually initially relieve the pain, but other medical procedures and surgery can also be used to relieve nerve pain.

  • Epidemiology of nervous disorder
  • Causes and risk factors: Damage to nerve
  • Risk factors: Compression of nerve by tumor or blood vessel
  • Symptoms: Attacks of nerve pain on the face
  • Ninth cranial nerve
  • Tenth cranial nerve
  • Diagnosis and examinations
  • Treatment of glossopharyngeal neuralgia
  • Prognosis of condition


Epidemiology of nervous disorder

Glossopharyngeal neuralgia is a rare condition. The symptoms of glossopharyngeal neuralgia usually begin in people over 50. Women are slightly more likely than men to suffer from this form of facial pain.

Causes and risk factors: Damage to nerve

Glossopharyngeal neuralgia is the result of irritation of the ninth cranial nerve: the glossopharyngeal nerve. The glossopharyngeal nerve is the ninth (IX) cranial nerve, which arises from the brain stem in the skull. The nerve supplies sensation to the back of the throat and tongue and parts of the ear. The exact cause of glossopharyngeal neuralgia is not known (October 2020).

Risk factors: Compression of nerve by tumor or blood vessel

There is usually a blood vessel present that compresses the nerve. A tumor at the base of the skull that presses on the glossopharyngeal nerve is also a risk factor. Tumors or infections of the throat and mouth that press on the glossopharyngeal nerve are other risk factors. Patients with throat cancer or neck cancer are also more likely to be affected by this nerve disorder. Finally, aging and multiple sclerosis are other factors that increase the risk of nerve disease.

Symptoms: Attacks of nerve pain on the face

Ninth cranial nerve

Glossopharyngeal neuralgia involves repeated episodes of severe burning or pricking pain in the face, more specifically in the tongue (tongue pain), the throat (sore throat), the ears (ear pain in the external auditory canal), the tonsils or the area below the angle of the jaw ( jaw pain). The nerve pain usually affects one side of the throat, but one in four patients affects both sides. These attacks of intense stabbing, shooting, and sharp pain (which feel like electric shocks) often appear without warning, or alternatively they occur when swallowing, chewing, talking, coughing, yawning, or laughing. The episodes last from several seconds to several minutes. The attacks return over several days or weeks and then the patient enters a remission of several months or years with no symptoms.

Tenth cranial nerve

Approximately 10% of patients develop potentially life-threatening episodes of heart defects because the nearby vagus nerve (the tenth (X) cranial nerve) is also affected. A slow pulse, a sudden drop in blood pressure, fainting (syncope) and seizures are possible symptoms.

Diagnosis and examinations

Physical examination A doctor touches the back of the throat with a cotton swab to try to provoke an attack of pain. If this causes pain, the doctor will apply a local anesthetic to the back of the throat and repeat the pain stimulus. If the pain is not triggered while the area is numb, the doctor will diagnose glossopharyngeal neuralgia.Diagnostic examination The doctor sometimes uses an MRI scan or MRA scan to detect tumors or to visualize a blood vessel that compresses the nerve.Differential diagnosis Glossopharyngeal pain is comparable to trigeminal neuralgia (facial pain with shooting pains) and therefore a doctor sometimes makes the wrong diagnosis. A neurosurgeon who specializes in facial pain is best placed to make the distinction.

Treatment of glossopharyngeal neuralgia

Many treatments are available to relieve facial pain caused by glossopharyngeal neuralgia. The doctor uses medications (anticonvulsants), a needle procedure, radiotherapy and/or surgery. He usually prescribes medication first, and only if this does not help or if serious side effects occur does the doctor discuss other procedures with the patient. Occasionally, surgery (microvascular decompression) is the only treatment option. The surgery does carry a small risk of swallowing problems, unilateral hearing loss, stroke (insufficient blood supply to the brain), imbalance, pain in the area of the incision (surgical incision), and a cerebrospinal fluid leak or infection.

Prognosis of condition

The patient initially feels short, mild attacks, with periods of remission (no symptoms present). However, glossopharyngeal neuralgia may be progressive, causing longer, frequent attacks of burning pain.

read more

  • Facial pain: Causes of facial pain
  • Nerve pain (neuralgia): Pain due to nerve damage
  • Sore Throat: Causes of Sore Throat (Sore Throat)
  • Tongue pain: Causes of sore tongue (tongue pain)
  • Neuropathic pain: Pain due to damage to the nervous system