Neto, et al., J Pain Relief 2015, 4:6 DOI: 10.4172/2167-0846.1000205 Case Report Open Access Volume 4 • Issue 6 • 1000205 J Pain Relief ISSN: 2167-0846 JPAR an open access journal Glossopharyngeal Neuralgia: Case Report Sergio Neto 1,* , Kleber Duarte 2 , Guilherme Alves Lepski 2 , Leonardo Moura 1 , Nilton Caetano da Rosa 3 and Manoel Jacobsen Teixeira 1,2 1 Division of Neurosurgery, University of Sao Paulo School of Medicine, Sao Paulo, Brazil 2 Division Functional Neurosurgery, University of São Paulo School of Medicine, São Paulo, Brazil 3 Division of Surgical Oncology, International Research Center, A.C. Camargo Cancer Center, São Paulo, Brazil Abstract Glossopharyngeal neuralgia (GPN) is an unusual cause of facial pain, corresponding to approximately 0.2-1.3%. Patients usually presents with facial pain associated with daily life activities (cough, swallow) and in severe cases with syncop. Epidemiology of the pathology demonstrates controversy about the predominance of the male, being consensus from patients over 50 years. We present a case report of a 51 patient diagnosed and treats for this rare disease with good outcome. Keywords: Glossopharyngeal neuralgia; Pain; Headache Abbreviations: GPN: Glossopharyngeal Neuralgia; GKS: Gamma Knife Surgery; MRI: Magnetic Ressonance Imaging; CT: Computarized Tomography Introduction Glossopharyngeal neuralgia (GPN) is an unusual cause of facial pain, corresponding to approximately 0.2-1.3% of patients with facial pain [1]. Te frst clinical description was assigned to weisenberg 1910 [2]. Te practice of patients is usually sudden afecting the glossopharyngeal nerve path, characterized by pain triggered by swallowing, chewing, coughing, talking, and may or not be associated with syncop frames/ cardiorespiratory stop in rare cases [3,4]. Te clinical or surgical treatment options may include the use of anticonvulsants and in severe or selected cases neurovascular decompression or Gamma Knife surgery [5-8]. Case Report 51-year-old male with pain in shock of sudden onset is 8 months of pain in neck region with irradiation to the region of hemiface right to Franca worsens when swallowing and chewing. Sick said several paroxysms, having 1 frequency crisis every 3 days. Afer investigation in another service with trigeminal neuralgia, chance of requested the evaluation team. In the frst assessment the patient was in use of Gabapentin 900 mg/d with inadequate control of paroxysms. Neurological examination: alert and oriented gear without changes and without strength defcits and/or sensitivity of note the same featured pain swallowing and spontaneous cough. Right Gag Refex abolished without deviation of the uvula. Magnetic resonance imaging illustrated a great right neurovascular confict between posteroinferior Cerebellar artery with glossopharyngeal nerve (Figures 1 and 2). Te patient underwent a retrossigmoid craniotomy and neurovascular decompression of glossopharyngeal nerve, having in the frst post-operative presented fully symptomatic improvement, having received high in the 4th post-operative without complaints and medications until 1st year outpatient follow up. Discussion Glossopharyngeal neuralgia (GPN) is an unusual cause of facial pain, corresponding to approximately 0.2-1.3% of patients with facial pain or a hundred times less frequent when compared with trigeminal neuralgia [1]. Te frst description of the clinic was assigned to Weisenberg 1910 in a patient with pontocerebelar angle tumor diagnosis and Harris in 1926 the name of glossopharyngeal neuralgia [2,9] Figure 1(A): MRI T2seq. FIESTA: Right vascular compression/Confict. *Corresponding author: Neto S, Division of Neurosurgery, University of Sao Paulo School of Medicine. Sao Paulo, Brazil. Address: Dr. Enéas de Carvalho Aguiar Street, 255-5th Floor, Zipcode: 05403-000-São Paulo. Brazil, Tel: 55 11 3091-3116; E-mail: sgsnnc@gmail.com Received August 18, 2015; Accepted October 27, 2015; Published October 30, 2015 Citation: Neto S, Duarte K, Lepski GA, Moura L, da Rosa NC, et al. (2015) Glossopharyngeal Neuralgia: Case Report. J Pain Relief 4: 205. doi:10.4172/21670846.1000205 Copyright: © 2015 Neto S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Te etiology of trigeminal neuralgia in most cases is primary/ idiopathic or secondary to neurovascular compression (posteroinferior Cerebellar arteries or branches of verteral arteries), skull base tumors or cerebellar point angle tumors [10]. Epidemiology of the pathology demonstrates controversy about the predominance of the male, being consensus from patients over 50 years [10]. Te clinic of patients is usually sudden afecting the glossopharyngeal nerve path, characterized by pain (unilateral electric shock type, abrupt, and located in the ear, at the base of the tongue, tonsillar fossa, or under the angle of the mandible) triggered by swallowing, chewing, coughing, talking, and may or not be associated with sincopais frames/ cardiorespiratory stop in rare cases [3,4] Te investigation of patients with neuralgia includes realization of head CT and/or Brain MRI in order to highlight tumors or vascular Journal of Pain & Relief J o u r n a l o f P a i n & R e l i e f ISSN: 2167-0846