Question

What doctor do you see for glossopharyngeal neuralgia?

Answer 1

The doctor that you see for glossopharyngeal neuralgia is your primary care physician doctors.

If glossopharyngeal neuralgia is suspected then, your primary care physician will often refer you to a neurologist for diagnosis and medical management and for advanced and specialized treatment you may be referred to a neurosurgeon.

After a primary care physician for the glossopharyngeal neuralgia, a neurologist is often the first point of specialized car for diagnosis, medical history, evaluation and prescription of any needed nerve stabilizing medications like carbamazepine or gabapentin.

A interventional pain specialist can also provide you with targeted nerve blocks or injections to help manage any pain or assist in confirming of the diagnosis of glossopharyngeal neuralgia.

An otolaryngologist is often also consulted early to rule out any other ear, nose and throat conditions that can mimic the symptoms of glossopharyngeal neuralgia.

And because glossopharyngeal neuralgia is rare and often misdiagnosed, you should seek out specialists at major neurosurgical centers and neurological centers who have the specific experience of treating cranial nerve disorders.

An MRI is also commonly used for diagnosing of glossopharyngeal neuralgia and is used to identify any potential causes of glossopharyngeal neuralgia, which include neurovascular compression, which is when a blood vessel presses against the nerve and less commonly tumors or other structural abnormalities near the nerve.

Doctors will often order high resolution or thin section MRI scans, often using the T2 weighted sequences like CISS or FIESTA to clearly visualize the cranial nerves.

A contrast enhanced MRI is often also used to detect abnormal tissue or inflammation and a magnetic resonance angiography or MRA may also be combined with the MRI to map the blood vessels better and confirm if they are compressing on the nerve.

Although, neurovascular contact can sometimes be seen in people who are asymptomatic and some people with symptoms may not show any clear compression on an MRI, so a diagnosis of glossopharyngeal neuralgia is mainly based on your symptoms and clinical history, with the MRI serving as a vital supportive tool for confirming the cause of glossopharyngeal neuralgia and guiding of any surgical treatment that might be needed.  

The triggers of glossopharyngeal neuralgia also known as GPN are chewing, swallowing, talking, sneezing, coughing, yawning and even laughing.

Other things that trigger GPN or glossopharyngeal neuralgia are touching the face, touching the neck, touching the ears or even drinking cold drinks, or even eating specific foods like sweet foods, sour foods or spicy foods as well as sudden head movements.

These things can trigger glossopharyngeal neuralgia or GPN and cause brief, intense, electric shock like episodes of pain.

Glossopharyngeal neuralgia can cause heart problems, and those heart problems that can be caused by glossopharyngeal neuralgia can also be serious heart problems.

Although the association with glossopharyngeal neuralgia and heart problems are rare and occur in around 2 percent of cases of glossopharyngeal neuralgia.

When the intense pain with glossopharyngeal neuralgia triggers the nearby vagus nerve, it can also cause what's called a "vagoglossopharyngeal reflex" which results in dangerous cardiovascular symptoms and problems, which include a slow heart rate also known as bradycardia, low blood pressure also known as hypotension, irregular heart rhythms also known as arrhythmias and fainting also known as syncope.

In extreme cases of glossopharyngeal neuralgia it can lead to cardiac arrest.

And because the glossopharyngeal nerve carries signals from your carotid sinus which is a blood pressure sensor, irritation can also trigger a reflex which mistakenly signals your body to drop it's blood pressure and heart rate.

And the pain signals from your glossopharyngeal nerve can also spill over or stimulate your vagal centers and the vagus nerve helps to regulate your heart rate and blood pressure, but when it's overstimulated it can cause your heart to slow down or even stop briefly.

The cardiac episodes can also result in a loss of consciousness also known as syncope, seizures as a result of reduced blood flow to the brain and if it's severe enough it can lead to cardiac arrest, which is life threatening.

Trigeminal neuralgia can be mistaken for glossopharyngeal neuralgia due to their shared status as cranial neuralgias that have similar lancinating pain.

Other conditions that are also mistaken with glossopharyngeal neuralgia are otic nerve pain also known as Jacobson's neuralgia, TMJ or temporomandibular joint and temporal arteritis.

Other throat, ear and dental infections as well as structural issues like tumors of your cerebellopontine angle or hypopharynx can also mimic glossopharyngeal neuralgia.

The best treatment for glossopharyngeal neuralgia are anticonvulsant medications like oxcarbazepine or carbamazepine to help control nerve pain.

For long term, relief of glossopharyngeal neuralgia, especially if medication fails or causes you side effects, then a surgical procedure called microvascular decompression surgery is a good treatment and considered the gold standard.

Microvascular decompression surgery has around an 80 percent success rate.  

The glossopharyngeal nerve can be relaxed through use of nerve blocks, chiropractic care and if needed through use of microvascular decompression surgery.

Medications that can help relax the glossopharyngeal nerve are anticonvulsants like Tegretol also known as carbamazepine, Neurontin also known as gabapentin and Trileptal also known as oxcarbazepine, which can help reduce nerve excitability.

Applying lidocaine the back of your throat can also provide some temporary relief from glossopharyngeal neuralgia.

Rhizotomy/Radiofrequency which are procedures to cut or damage specific nerves can help by stopping pain signals.

And stress management, like deep breathing, yoga, and meditation can reduce some pain intensity and therapeutic massage techniques like myofascial release and trigger point therapy can also reduce tension in the jaw and neck.

And even upper cervical chiropractic care can address any misalignments in your upper spine which can irritate the nerve.

The syndrome that is associated with the glossopharyngeal nerve is Weisenberg syndrome, also glossopharyngeal neuralgia.

The glossopharyngeal neuralgia or Weisenberg syndrome is a rare and often debilitating, neurovascular compression syndrome, which causes severe and sporadic and sharp pain in the areas that are innervated by the ninth cranial nerve.

The key symptoms and key features of glossopharyngeal neuralgia are excruciating, stabbing or shock like pain that often occurs unilaterally in your throat, tonsillar area, base of your tongue and deep in your ear.

The attacks with glossopharyngeal neuralgia are often triggered by simple and daily actions like swallowing, especially swallowing cold liquids, chewing, coughing, talking, sneezing or yawning.

The causes of glossopharyngeal neuralgia are often vascular compression, which is when a blood vessel, like an artery or vein, presses against the nerve near your brainstem.