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GLOSSOPHARYNGEAL NEURALGIA (SORE THROAT)
Glossopharyngeal neuralgia is a severe pain that develops behind the throat, tongue, or ear. Severe, electric shock-like pain attacks may occur without any warning or may be triggered during swallowing. Although the exact cause is unknown, a blood vessel is usually found compressing the nerve inside the skull. It can also occur in people with throat or neck cancer. Medications may initially relieve the pain, but surgery is usually required for long-term relief.
Neuralgia is severe pain caused by injury or damage to a nerve. The glossopharyngeal nerve is the ninth (IX) cranial nerve that arises from the brainstem inside the skull. It provides sensation to the back of the throat, tongue and some parts of the ear. When the glossopharyngeal nerve is irritated, an intense pain similar to an electric shock is felt in the throat, tongue, tonsils or behind the ear. You may experience short, mild attacks with periods of remission initially. But neuralgia can progress, causing longer, often searing attacks of pain.
Patients describe an episode of pain as a burning or stinging pain, or an electric shock that may last for several seconds or minutes. Swallowing, chewing, talking, coughing, yawning or laughing can trigger an episode. Some people describe the feeling of a sharp object stuck in the throat.
About 10% of patients have episodes of potentially life-threatening heart irregularities caused by nearby vagus nerve involvement, for example: slow pulse, sudden drop in blood pressure, fainting (syncope) and seizures.
Most often, the damage is caused by a blood vessel compressing the nerve. Other causes include decrepitude, multiple sclerosis and nearby tumors.
The diagnosis of neuralgia is made after carefully evaluating the patient’s symptoms. If glossopharyngeal neuralgia is suspected, the doctor will try to start an episode by touching the back of the throat with a stick. If this causes pain, a topical anesthetic is applied to the back of the throat, and the doctor will try the pain stimulus again. If pain is not triggered while the area is numb, glossopharyngeal neuralgia is diagnosed. Other tests may include an MRI or MRA to look for tumors or a blood vessel compressing a nerve.
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