Trigeminal neuralgia is the irritation of one of the 12 pairs of cranial nerves present in your face. The 5th nerve is known as the trigeminal nerve. It is manifested by acute pain that affects a side of the face. The pain, similar to electric shocks, occurs during certain stimulation such as smiling, shaving, drinking, brushing teeth, or chewing food1. In the absence of effective treatment, facial trigeminal is a serious handicap in everyday life. When it continues, it can lead to depression. Stress may aggravate the condition with no specific means to remit the pain1.
Can Trigeminal Neuralgia Cause Sore Throat?
Trigeminal neuralgia causes facial pain and does not associate with throat pain. Nerve pain that affects the throat region is known as glossopharyngeal neuralgia2. It produces sharp and appalling pain that happens intermittently. The pain is not constant and lasts for a brief period, but is characterized by recurrent episodes of intense pain. The pain is felt in the retropharynx, near the tonsils, at the base of the tongue, in part of the ear or under the back of the jaw. The pain is due to a functional abnormality of the 9th cranial nerve known as the glossopharyngeal nerve. This nerve helps move the throat muscles and transmits information from the throat, tonsils, and tongue to the brain2.
Common Features Of Glossopharyngeal Neuralgia
The etiology, although often unknown, usually happens due to the abnormal course of an artery, which exerts pressure on the glossopharyngeal nerve (compresses it). Individuals have brief episodes of unbearable pain, touching one side of the tongue or throat, and sometimes in the ear.
- The doctor makes the diagnosis based on the type of pain that occurs, and if a local anesthetic applied to the back of the throat eliminates the pain.
- Some anticonvulsants or antidepressants or a local anesthetic may relieve pain, but surgery may be necessary.
- Glossopharyngeal neuralgia is rare; it usually begins after age 40 and is most often seen in men3.
The exact etiology or cause of the disease is still not fully understood. However, the disorder usually occurs when2:
- A poorly positioned artery compresses the glossopharyngeal nerve near its emergence from the brainstem.
- The long, pointed bone at the base of the skull is abnormally long and compresses the nerve.
- In rare cases, the cause is a tumor in the brain or neck, an abscess, aneurysm in a neck artery (carotid artery), or multiple sclerosis.
In glossopharyngeal neuralgia, the episodes are brief and intermittent, but the pain is unbearable. Episodes can be triggered by a specific action, such as talking,
swallowing, yawning, chewing, coughing or sneezing. The pain usually starts at the back of the tongue or throat. It sometimes extends to the ear or the back of the jaw. It can last from a few seconds to a few minutes, and usually reaches only one side of the throat and tongue.
Diagnosis is done based on the symptoms and sometimes additional tests such as a CT scan, MRI or a cotton swab (from your throat) is done. Glossopharyngeal neuralgia differs from trigeminal neuralgia (which causes similar pain) by localization of pain2.
Course Of Treatment For Glossopharyngeal Neuralgia
The same drugs used for trigeminal neuralgia, such as anticonvulsants, tricyclic antidepressants, and analgesics can be used in glossopharyngeal neuralgia. If these medications are ineffective, application of a local anesthetic in the posterior part of the throat may provide temporary relief (this also confirms the diagnosis)2.
Surgical intervention may be needed where the glossopharyngeal nerve (compression of this nerve is responsible for the pain) is separated from the artery that compresses it, by the interposition of a small sponge4.
There are various types of neuralgia causing pain at different locations. Trigeminal neuralgia causes facial pain and often the glossopharyngeal neuralgia, which produces throat and ear pain is misdiagnosed as trigeminal neuralgia. The differentiation of these disorders can be done by identifying the location of the pain. Both conditions have similar treatment options and possible surgical intervention.
- Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis. Brain. 2001;124(12):2347-2360.
- Rozen TD. Trigeminal neuralgia and glossopharyngeal neuralgia. Neurologic clinics. 2004;22(1):185-206.
- Simpson C, Rahman N, Lamey P-J. Glossopharyngeal neuralgia: a case report. British Journal of Oral and Maxillofacial Surgery. 2019;57(5):486-487.
- Ganaha S, Grewal SS, Cheshire WP, Reimer R, Quiñones-Hinojosa A, Wharen RE. Surgical treatment of bilateral glossopharyngeal neuralgia. International Journal of Neuroscience. 2018;128(12):1204-1206.
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