Glossopharyngeal Neuralgia Treated with Microvascular Decompression

Abstract

Glossopharyngeal neuralgia (GPN) poses a unique challenge in that its clinical symptoms, especially pain in the facial area, can be misinterpreted as other cranial nerve and dental disorders. Microvascular decompression (MVD) is typically the definitive t reatment. We e ncountered a c ase i n w hich M VD was successfully performed to relieve pain in a patient with left-sided GPN in a 38-year-old male who presented with severe episodic pain in the tongue, cheek, and jaw. The patient had undergone dental surgery and pharmacological therapy only to experience temporary relief from gradually worsening clinical symptoms. Fiberoptic endoscopic evaluation of swallowing and brain magnetic resonance imaging with constructive interference in steady-state sequences were used to support the diagnosis of GPN. MVD was then performed to surgically relieve the vascular compression of the left glossopharyngeal nerve, resulting in significant clinical improvement. MVD could be an option to decrease pain and other symptoms in patients with GPN that could not be treated with pharmacological therapy.