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What causes glossopharyngeal neuralgia and how to treat it?
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What causes glossopharyngeal neuralgia and how to treat it? What is glossopharyngeal neuralgia?
Did you have the experience of sudden electric shock-like tingling in the throat after yawning, which disappeared after a few seconds? If there is, you should be alert for glossopharyngeal neuralgia. What is glossopharyngeal neuralgia? How to treat? Let’s find out together.
1. What is glossopharyngeal neuralgia?
Glossopharyngeal neuralgia is a kind of severe paroxysmal pain that occurs in the subregion of the glossopharyngeal nerve.
Glossopharyngeal nerve is the ninth of the twelve pairs of brain nerves in humans. It is mainly distributed in the pharynx, neck and base of the tongue.
Glossopharyngeal neuralgia is also mainly distributed in these areas.
2. How does glossopharyngeal neuralgia cause?
According to the different causes, it can be divided into primary glossopharyngeal neuralgia and secondary glossopharyngeal neuralgia. The etiology of primary glossopharyngeal neuralgia is unknown.
It may be caused by the compression of surrounding blood vessels, or the lack of myelin sheath of the cranial nerves in the posterior group, and the nerve short circuit mechanism caused by vascular compression; secondary glossopharyngeal neuralgia refers to the glossopharyngeal Tumors or other diseases near the nerve cause glossopharyngeal nerve damage, which can cause glossopharyngeal neuralgia.
Glossopharyngeal neuralgia can be caused by a series of actions such as laughing, talking, swallowing, sneezing, and yawning.
3. What are the symptoms of glossopharyngeal neuralgia?
The most typical symptom of glossopharyngeal neuralgia is pain. Glossopharyngeal neuralgia has a sudden onset like burning, electric shock, and acupuncture.
The pain is severe and lasts for a short period of time, usually ranging from a few seconds to 2 minutes, and from several to several per day.
Ranging from dozens of times. Pain usually starts behind the tongue, the back of the throat, or near the tonsils, and then spreads to the back of the ears or chin.
In addition, there may be accompanying symptoms such as increased salivation, difficulty speaking and swallowing, and throat spasms.
4. How to distinguish glossopharyngeal neuralgia from other diseases?
Glossopharyngeal neuralgia is easily confused with diseases such as trigeminal neuralgia. Patients can make preliminary judgments based on the nature of the pain and the location of the pain.
The more professional method is to find the onset of diagnosis: the “trigger point” of glossopharyngeal neuralgia is mostly in the back of the pharynx, tonsil fossa and the base of the tongue.
In order to further confirm the diagnosis, the patient’s “trigger point” can be stimulated to see if it can induce glossopharyngeal neuralgia.
In addition, 1% of tetracaine can be sprayed onto the posterior pharynx and tonsil fossa. If it can stop the pain, it means that the patient has glossopharyngeal neuralgia.
If the pain in the glossopharyngeal area disappears after the patient sprays, but the ear area is still painful, the jugular vein hole can be closed to see if it can converge.
If it can converge, the patient not only has glossopharyngeal neuralgia, but also the posterior branch of the vagus nerve.
If the patient has persistent pain, or has positive neurological signs, it should be considered whether it is secondary glossopharyngeal neuralgia, and the doctor must perform further examinations at this time to determine the cause.
In addition, some imaging tests such as head X-rays, CT scans, magnetic resonance, angiography, etc. can also help confirm the diagnosis.
5. What are the treatment methods for glossopharyngeal neuralgia?
If it is secondary glossopharyngeal neuralgia, it is good to treat the tumor or other pathological changes that cause glossopharyngeal neuralgia.
For primary glossopharyngeal neuralgia, there are two methods of medical treatment and surgical treatment.
It is generally used in the initial stage of glossopharyngeal neuralgia for the purpose of reducing pain and delaying the onset.
General pain medicines have almost no effect on glossopharyngeal neuralgia. Commonly used drugs are as follows:
(1) Antiepileptic drugs: Carbamazepine is the most commonly used, but it has some toxic side effects, and the effect is not as obvious as trigeminal neuralgia.
(2) Antidepressants: Baclofen, tricyclic drugs;
(3) Vitamin B12 can nourish nerves and relieve pain.
Surgical treatment is available for patients who have repeated attacks that lead to ineffective drug treatment.
The most effective operation is microvascular decompression.
The principle is to place a decompression cotton pad between the oppressed glossopharyngeal nerve and the blood vessel to eliminate the compression on the nerve. , Thereby eliminating pain.
The specific operation process is:
- Under the microscope, the patient undergoes surgery under general anesthesia
- Make a 5cm straight incision behind the affected ear and inside the hairline. Make a hole in the skull with a diameter of about 1.5cm.
- Enter the cerebellopontine angle area under a microscope to explore the glossopharyngeal nerve walking area
- Loosen all the blood vessels and arachnoid cords that may cause compression, and isolate these blood vessels from the nerve roots with bio-shims
Once the responsible blood vessels are isolated, the source of the irritation disappears, and the high excitability of the glossopharyngeal nucleus will disappear and return to normal.
The pain of most patients disappeared immediately after the operation, and the normal feeling and function were retained without affecting the quality of life.
Microvascular decompression has a series of advantages such as high cure rate, high safety, minimal invasiveness, mature technology, and simple operation, making it the first choice for surgical treatment of glossopharyngeal neuralgia.
What causes glossopharyngeal neuralgia and how to treat it?
(source:internet, reference only)