Question

What triggers GPN?

Answer 1

The triggers of GPN also known as glossopharyngeal neuralgia 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.

Structural lesions like tumors at the base of your skull, or cerebellopontine angle, infections or demyelinating diseases like multiple sclerosis and even eagle syndrome, which is an elongated styloid process or calcified stylohyoid ligament compressing the nerve.

If there is damage to the glossopharyngeal nerve, it results in difficulty swallowing also known as dysphagia as well as loss of taste or a bitter and or sour taste on the posterior third of your tongue and a reduced sensation in your palate/pharynx as well as an absent gag reflex and reduced salivation.

Damage to the glossopharyngeal nerve can also cause severe pain or neuralgia in your ear, throat or even tongue.

The common symptoms of damage to the glossopharyngeal nerve are dysphagia or difficulty swallowing, which can result in food getting stuck in your throat.

Loss of taste and loss of sensation on the posterior one third of your tongue and palate.

Decreased or absent sensation on your throat, palate and posterior tongue.

Diminished or absent gag reflex

Reduced saliva production, which leads to dry mouth.

And rare cases of a glossopharyngeal nerve being damaged can lead to neuralgia, which results in intense, stabbing pain in your throat, tongue or ear also known as glossopharyngeal neuralgia.

And your uvula might deviate to the side opposite the injury with glossopharyngeal nerve damage.

These symptoms of glossopharyngeal nerve damage often result from injury during procedures such as tonsillectomies or even from compression of the nerve by blood vessels or tumors pressing on the nerves or blood vessels.

The way glossopharyngeal nerve damage is treated through antiseizure medications like carbamazepine.

And antidepressants can help some people and in severe cases, when the pain with glossopharyngeal nerve damage is difficult to treat, surgery may be needed to take the pressure off the glossopharyngeal nerve.

The surgery for glossopharyngeal nerve damage to relieve the pressure off the glossopharyngeal nerve is called microvascular decompression surgery.

The glossopharyngeal nerve can sometimes regenerate through holes in the sieves.

In studies axons of the glossopharyngeal nerve regenerated through holes in the sieves and supported the functional regeneration of taste, thermal and mechanoreceptors.