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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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