Glossopharyngeal neuralgia (GPN) is a pain syndrome characterized by attacks of severe
pain in the sensory distribution of the glossopharyngeal nerve. Most cases of GPN
respond to treatment with carbamazepine and other anticonvulsants. The causative element
of essential GPN appears to be a vascular compression of the glossopharyngeal nerve
root and the upper rootlets of the vagus nerve; therefore, the most definitive surgical
treatment consists of microvascular decompression of the ninth (and tenth) nerve in
the posterior cranial fossa. In cases of secondary GPN and when microvascular decompression
is not possible, intracranial rhizotomy of the glossopharyngeal and upper portion
of the vagal nerve roots may be the next logical step in surgical management. Extracranial
neurotomy and percutaneous radiofrequency rhizotomy are useful for patients with GPN
who have failed medical treatment but for some reason cannot undergo intracranial
intervention.
Glossopharyngeal neuralgia - neurovascular compression - neurotomy - rhizotomy - microvascular
decompression
