Glssopharyngeal Neuralgia

8/8/2019 Glssopharyngeal Neuralgia

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Glossopharyngeal neuralgia

By : Francis prathyusha


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Definition: The glossopharyngeal nerve is theninth cranial nerve (9th).

So the glossopharyngeal nerve is the nerve thatserves the tongue & throat.

comes from the Greek

"glossa", the tongueglosso

is the Greek for throatpharynx


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Origin:

from the

brain stem

(medulla)

by 3 nuclei ;

1)Sensory

(solitary nucleus)

2)Motor

(nucleus

ambiguus) in medulla

SVE

&

3)Parasympathetic(inferior salivarynucleus)


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Branches:

1. Motor branch; for one muscle(stylopharyngeus muscle).

2. Parasympathetic branch; for parotid gland

3.Sensory branches


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3. Sensorybranches:

A-.

B- Lingual br; for

general sensationand taste of theposterior 1/3 oftongue.

C-

D- Carotid br; supply

carotid sinus andcarotid body.

Pharyngeal br; formucosa oforopharynx.

Tonsillar branch;for palatine tonsiland soft palate


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The 12 cranial nerves including theglossopharyngeal nerve, emerge from or enter the

skull, unlike the spinal nerves which emerge fromthe vertebral column.

Problems with the glossopharyngeal nerveresult in trouble in taste & swallowing

The glossopharyngeal nerve supplies thetongue, throat, & one of the salivary glands (theparotid gland).


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Glossopharyngeal neuralgia

severe pain in (back of the throat, area near tonsils,back of tongue, and part of the ear).

rare disorder

begins after age 40 and occurs more in men

its cause is unknown.

Rarely, the cause is a tumor in the brain or neck


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GPN) is also called vagoglossopharyngealneuralgia

It s characterized by brief but intense pain on oneside of the throat, which may radiate within the

mouth or into the ear. Attacks are described assharp, stabbing or burning in quality. They mayoccur spontaneously or be provoked by talking,

chewing, swallowing, coughing and yawning.


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May be confused with pain emanating from TMJ

or masticatory muscles

The pain can be provoked by touching the lateralaspect of the throat


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This neuralgia can occur in conjugation withtrigeminal neuralgia

When the pain is felt more deeply in the ear regiontympanic plexus neuralgia

The ear pain may be excruciating .

Such neuralgia may be indistinguishable fromgeniculate neuralgia when that disorder occurs only

in the ear .

Precise differentiation may at times require underlocal anesthesia and direct stimulation to determine

which nerve is involved.


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Three forms of GPN can be distinguished:

1. Typical GPN is usually caused by vascular

compression of the IXth and Xth cranial nerve

rootlets entering the lateral medulla

2. Atypical GPN involves a prominent associated aching

or burning pain in the involved side of the face.

3. Secondary GPN is caused by a tumor injuring the

glossopharyngeal nerve in the neck or base of the

skull . GPN is rarely associated with multiple-

sclerosis


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Diagnosis

DIAGNOSE: For the test, a doctor touches the back of the

throat with a cotton-tipped applicator. If pain results, thedoctor applies a local anesthetic to the back of the throat.


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CLINICAL DIFFERENTIATION GLOSSOPHARYNGEAL

1. Masticatory pain has the clinical features of deep

somatic pain, where as glossopharyngeal neuralgiais neuropathic

2. Masticatory pain is arrested or decreased by

immobilization of the mandible with a bite block. Thisdoes not prevent triggering by tongue movementand swallowing

3. Masticatory pain is not arrested by

application of a topical anesthetic tothe pharyngeal mucosa, butglossopharyngeal neuralgia can beif the trigger area is anesthetized.


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Treatment


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DRUGSEx.

TEGRETOL

NEURONTINDILANTIN

LIORESAL


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A glossopharyngeal block

peristyloid technique

applying a local anesthetic(such as cocaine) to theback of the throat(temporary relief).


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PERMANENT RELIEF: surgery may be needed. Theglossopharyngeal nerve is separated from the artery that

is compressing it by placing a small sponge betweenthem


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You tube.. Brain surgery


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Glssopharyngeal Neuralgia

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