• 한방안이비인후피부과학회지
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• 제28권2호
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• pp.102-111
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• 2015

Objective : This study reports the effect of Korean medicine on one case diagnosed as idiopathic glossopharyngeal neuralgia. Methods : We experienced one case with idiopathic glossopharyngeal neuralgia treated with acupuncture, herbal medicine and gargling. Associated symtoms had been estimated with change of VAS(Visual Analogue Scale), severity of dysphagia, and diet type. Result : After the treatment, symptoms were decreased and almost disappered. In this case, VAS and severity of dysphagia decreased from 10 to 1 and from severe to subsided, and diet type changed from unable to DD4(Dysphagic Diet 4) during 21 days. Conclusion : This study suggests that Korean medicine is effective on idiopathic glossopharyngeal neuralgia.

• The Korean Journal of Pain
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• 제12권1호
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• pp.119-122
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• 1999

Glossopharyngeal neuralgia is a rare syndrome that involves episodic bursts of pain in the sensory distributuion of the ninth cranial nerve. The nature of the pain is characterized by excruciating shock-like pain in the region of the tonsillar fossa or pharynx and can radiate to the ear or the angle of the jaw. Like trigeminal neuralgia, glossopharyngeal neuralgia typically responds to anticonvulsant agents such as carbamazepine. However, dose of carbamazepine needs to be increased gradually to avoid side effects. If the patient can not tolerate until effective carbamazepine level is reached, phenytoin can be administered intravenously at the same time that oral carbamazepine therapy is begun. We present fifty-three year old female patient suffering from glossopharyngeal neuralgia who did not respond to initial carbamazepine therapy, but responded to concomitant intravenous infusion of phenytoin.

• Journal of Acupuncture Research
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• 제17권4호
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• pp.180-187
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• 2000

By process of treatment for a case which diagnosed as glossopharyngeal neuralgia and admitted from the 4th, August, 2000 to the 1st, September, 2000, the results are as follows. Method & Resuits : This patient was diagnosed as Flaring up of Heart-fire(心火上炎), medicated Gamichengsimyeonja-eum(JiaWeiQingXinLianZi-Yin) and acupunture therapy was taken on proximal acupoints of right throat and parotid and distal acupoints inciuding Yuji(L10, 魚際), Taixi(K6,太谿), Zhaohai(K3, 照海), Hegu(LI4, 合谷) and Taichong(Liv3, 太衝). And negative therapy was taken on some pressure points of Jianzhongshu(SI15, 肩中兪) Jianjing(G21, 肩井) and Futu(LI18, 扶突). As a result, the patient's paroxysmal megalgia was improved. Conclusion : I consider that idiopathic pain diseases including glossopharyngeal neuralgia can improved by Oriental-Western collaborative medical treatment and continuous research must be accumulated subsequently.

• Journal of Acupuncture Research
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• 제39권3호
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• pp.229-233
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• 2022

Glossopharyngeal neuralgia is a skin-sensitive condition/disease that causes severe pain in the facial area predominantly innervated by the glossopharyngeal nerve. A 51-year-old man diagnosed with glossopharyngeal neuralgia who was hospitalized with severe pain that limited his daily life activities. From November 18, 2021, to March 4, 2022, he received inpatient (10 days) and outpatient treatment (35 times) using acupuncture, pharmacopuncture, and herbal medicine. His symptoms were assessed using the Numerical Rating Scale, Neuropathic Pain Scale, and the Self-report Leeds Assessment of Neuropathic Symptom and Signs. The pain reduced after 4 days of initiating Korean medicine treatment and was completely resolved within 4 months of treatment (Numerical Rating Scale score 4 to 0; Neuropathic Pain Scale score 49 to 8; Self-report Leeds Assessment of Neuropathic Symptoms and Signs score 18 to 0). Korean medicine treatment could be an option for treating patients with neuropathy who rely on analgesics.

• Journal of Korean Neurosurgical Society
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• 제56권2호
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• pp.149-151
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• 2014

The cerebello-pontine angle lipomas causing trigeminal neuralgia or hemifacial spasm are rare. A lipoma causing glossopharyngel neuralgia is also very rare. A 46-year-old woman complained of 2-year history of severe right throat pain, with ipsilateral episodic otalgic pain. The throat pain was described as an episodic lancinating character confined to the throat. Computed tomography and magnetic resonance imaging revealed a suspicious offending posterior inferior cerebellar artery (PICA) compressing lower cranial nerves including glossopharyngeal nerve. At surgery, a soft, yellowish mass ($2{\times}3{\times}3mm$ in size) was found incorporating the lateral aspect of proximal portion of 9th and 10th cranial nerves. Only microvascular decompression of the offending PICA was performed. Additional procedure was not performed. Her severe lancinating pain remained unchanged, immediate postoperatively. The neuralgic pain disappeared over a period of several weeks. In this particular patient with a fatty neurovascular lump causing glossopharyngeal neuralgia, microvascular decompression of offending vessel alone was enough to control the neuralgic pain.

• Journal of Korean Neurosurgical Society
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• 제66권1호
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• pp.12-23
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• 2023

Glossopharyngeal neuralgia (GPN) is a rare disease that must be differentiated from trigeminal neuralgia. The purpose of this article is to provide a comprehensive review of anatomy, pathophysiology, diagnostic criteria, and several options of treatment for GPN. Lessons learned through our experience of treating GPN are presented in detail, as well as cases of misdiagnosis and diagnostic pitfalls. Microvascular decompression (MVD) should be primarily considered for medically intractable GPN. Techniques employed in MVD for GPN are categorized and described. Especially, we underscore the advantages of the 'transposition' technique where insulating material is positioned 'off' the root entry zone (REZ), instead of 'on' it. We believe this 'off-the-REZ' technique can fundamentally prevent recurrence, if applicable. In addition, Gamma Knife radiosurgery can be an alternative option when a patient is ineligible for MVD, though it is categorized as a destructive procedure.

• The Korean Journal of Pain
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• 제23권3호
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• pp.215-218
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• 2010

Glossopharyneal neuralgia (GPN) is generally considered to be a pain disease. However, it can be also be a life-threatening cardiac cause of syncope. Neuralgia in the throat and neck can trigger severe bradycardia up to the point of asystole, which can progress to cardiac syncope with or without seizures. A 65 year-old male patient diagnosed with glossopharyngeal neuralgia complained of severe paroxysmal pain in his right chin and ear followed by bradycardia, aystole and syncope. We report a case successfully treated with a permanent pacemaker and carbamazepine in a patient with GPN who had syncopal attacks preceded by paroxysms of pain.

• Journal of Korean Neurosurgical Society
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• 제49권5호
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• pp.284-286
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• 2011

Glossopharyngeal neuralgia is a relatively rare condition characterized by severe, paroxysmal episodes of lancinating pain in the tongue, throat, ear, and tonsil. This disorder is assumed to be due to compression of the glossopharyngeal nerve by vascular structures. A 47-year-old woman complaining of sharp and lancinating pain in the right periauricular and submandibular areas visited our hospital. Swallowing, chewing, and lying on her right side triggered the pain. Her neurologic examination revealed no specific abnormalities. The results of routine hematologic and blood chemistry studies were all within normal limits. Carbamazepine and gabapentin were given, but her symptoms persisted. Her pain was temporarily relieved only by narcotic pain medication. MRI showed an arachnoid cyst located in the right cerebellomedullary cistern extending to the cerebellopontine cistern. Cyst removal was performed via a right retrosigmoid approach. Lateral suboccipital craniotomy was performed using the right park-bench position. After opening the dura and cerebellopontine angle, the arachnoid cyst was exposed. The arachnoid cyst was compressing the flattened lower cranial nerves at the right jugular fossa. Her symptoms resolved postoperatively. Two months after the operation, she was completely free from her previous symptoms.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.738-748
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• 2017

Objective : We present our experience of microvascular decompression (MVD) for glossopharyngeal neuralgia (GPN) and evaluate the postoperative outcomes in accordance with four different operative techniques during MVD. Methods : In total, 30 patients with intractable primary typical GPN who underwent MVD without rhizotomy and were followed for more than 2 years were included in the analysis. Each MVD was performed using one of four different surgical techniques : interposition of Teflon pieces, transposition of offending vessels using Teflon pieces, transposition of offending vessels using a fibrin-glue-coated Teflon sling, and removal of offending veins. Results : The posterior inferior cerebellar artery was responsible for neurovascular compression in 27 of 30 (90%) patients, either by itself or in combination with other vessels. The location of compression on the glossopharyngeal nerve varied; the root entry zone (REZ) only (63.3%) was most common, followed by both the REZ and distal portion (26.7%) and the distal portion alone (10.0%). In terms of detailed surgical techniques during MVD, the offending vessels were transposed in 24 (80%) patients, either using additional insulation, offered by Teflon pieces (15 patients), or using a fibrin glue-coated Teflon sling (9 patients). Simple insertion of Teflon pieces and removal of a small vein were also performed in five and one patient, respectively. During the 2 years following MVD, 29 of 30 (96.7%) patients were asymptomatic or experienced only occasional pain that did not require medication. Temporary hemodynamic instability occurred in two patients during MVD, and seven patients experienced transient postoperative complications. Neither persistent morbidity nor mortality was reported. Conclusion : This study demonstrates that MVD without rhizotomy is a safe and effective treatment option for GPN.

• Journal of Oral Medicine and Pain
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• 제33권4호
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• pp.353-374
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• 2008

비록 신경병성 동통이 환자에게 주는 심리적 부담에 대하여 잘 알고 있지만 동통의 역학조사에 대해서는 아직 잘 알려져 있지 않다. 신경병성 동통의 정확한 발병률도 잘 알려져 있지 않은 데, 이는 여러가지 새로운 의료기기가 개발되었지만 정확한 진단을 하지 못하고 있으며, 적절한 치료를 제대로 하지 못하기 때문이다. 본 연구의 목적은 한국내 모든 종류의 병원에서 치료한 몇 가지 특정 신경병성 동통에 대하여 역학조사를 시행하는 것이다. 2003년 1월부터 2005년 12월까지 건강보험심사평가원(심평원)의 전산에 입력된 환자들을 대상으로 조사한 신경병성 동통 환자와 치료 받은 과 및 치료기간 등에 대하여 조사하였다. 신경병성 동통 환자의 수와 유병률을 살펴보면 삼차신경통 77,053명(27.6%), 비정형적 안면통 12,382명(4.4%), 설인후 신경통 1,319명(0.5%), 포진후 신경통 84,598명(30.3명), 당뇨병성 신경통 85,989명(30.8%), 비정형적 치통 16,001명(5.7%), 설통 2,133명(0.8%) 이며, 시간이 경과함에 따라 포진후 신경통과 당뇨병성 신경통은 증가하는 경향을 보이나, 그 외 신경통은 대부분 증가가 둔화되는 양상을 보였다. 대부분의 환자들은 57.6-72.8% 에 이르도록 1차 의료기관인 개인의원에서 치료받았으나 비정형적 치통의 경우에만 10.3% 정도로 1차 의료기관에서 진료받는 비율이 낮았다. 치과의원에 내원하는 환자의 비율은 삼차신경통 3.2%, 비정형적 치통 35.4%, 설통 15.4%이며 그 외 나머지 신경병성 동통은 대부분 의원에서 치료받았다.