Trigeminal and glossopharyngeal neuralgia

Trigeminal and glossopharyngeal neuralgias are diseases characterized by chronic intense painful events.

With regard to trigeminal neuralgia (5th cranial nerve), the face is affected, presenting with pain in the eye region, ear, nose, cheek, mouth and mandible. Among the different causes, it may be secondary to a tumor or a vessel adjacent to the trigeminal nerve.

Glossopharyngeal neuralgia is characterized by pain irradiating through cranial nerves 9 and 10, mostly on the pharynx, tongue, ear, and below the mandible. It may be caused by a compression of a vessel to the 9th and 10 th cranial nerves, similar to a trigeminal neuralgia. Occasionally it may be secondary to tumor, abscess, brain aneurysm or demyelinating disease.

In order to establish the correct diagnosis and proper studies, a thorough clinical evaluation should be performed, most cases require an MRI in order to define the exact cause.

Depending on the exact cause, pharmacological therapy is the initial treatment, and surgery is performed when side effects or recurrent symptoms present even with proper medical management.

Other alternatives include percutaneous infiltration of the nerve in order to anesthetize it such as the Mullan or Gasser technique.

Since one of the most important causes of neuralgia is secondary to nerve compression, microvascular decompression surgery, also known as Jannetta’s procedure, should be considered.