Imagine if you were having a good laugh and conversation with your friends, or enjoying your favorite food, and suddenly you felt an unbearable electric shock coming from the back of your throat or tongue? This severe pain that comes and goes in a matter of seconds can upset your whole day. If you have had such an experience, it is very important for you to be aware of the condition we are talking about today called Glossopharyngeal Neuralgia (GPN).
What is Glossopharyngeal Neuralgia (GPN)?
Simply put, GPN is a very rare condition that causes sudden, severe pain in your tongue, throat , tonsils , and ears. It is caused by pressure or damage to the glossopharyngeal nerve .
There are 12 main pairs of nerves that run from our brain to our face and neck, called cranial nerves . The glossopharyngeal nerve is the ninth of these. There are two of these nerves on each side of your head. However, in GPN, it usually only affects one side of the head.
This pain can occur at times when we don't even think about it, such as when you eat, talk, laugh, urinate, or open your mouth. This pain can last from a few seconds to about two minutes. However, since this pain can occur several times a day, it can be a major disruption to life. But don't worry, there are good treatments to control these symptoms.
Are there main types of GPN?
Yes, GPN can be divided into two main types depending on the cause.
| GPN type | Description |
|---|---|
| Primary GPN | This is also called idiopathic GPN . Idiopathic means "no cause can be found." This means that the condition occurs without a clear cause. |
| Secondary GPN | This is caused by pressure on the nerve due to another medical condition, infection, or something like a tumor. |
What are the symptoms? How do we recognize this pain?
The main and only symptom of GPN is pain. This pain can be felt in different ways.
| Nature of pain | Simply put... |
|---|---|
| Sharp | A very sharp, stabbing pain. |
| Stabbing | A sudden, severe pain that feels like being stabbed with a knife. |
| Shooting | A pain that starts in one place and moves to another with lightning speed. |
| Shocking | A numbing pain, like being electrocuted. |
| Aching | A stabbing pain coming from within. |
| Like a burning (Burning) | A burning pain in the throat. |
This pain usually lasts from a few seconds to two minutes . It can come several times a day. Sometimes the pain can be so severe that it wakes you up at night. This pain can last for weeks or months, then go away for months or even years.
Where does the pain come from?
Because the glossopharyngeal nerve is connected to several areas of the head, neck, and face, pain can come from several places.
- The back of your nose, mouth, and throat (especially around the tonsils).
- The throat area around the voice box.
- The area around and under your chin and ears.
- The back of the tongue.
Often the pain is only on one side of the head. Sometimes the pain can start in one place and spread to the shoulder or back (radiating pain).
What are the causes of GPN?
As mentioned earlier, the main cause of this is damage to the glossopharyngeal nerve. There are several common causes that can contribute to this:
- Nerve compression by a blood vessel: Pain can occur when a blood vessel that runs near a nerve presses on the nerve.
- A tumor or cancer: A tumor that forms around the nerve can cause the nerve to become compressed.
- Infection: An infectious condition can cause the nerve to become inflamed.
Sometimes doctors can't figure out exactly why this nerve is being affected. It can also be caused by other underlying medical conditions. For example:
- Autoimmune diseases like Sjögren's syndrome .
- Diseases that affect the nervous system, such as multiple sclerosis ( MS ).
- Eagle syndrome.
- An accident to the head or neck.
- Schwannomas (tumors that form in the nerve sheaths).
- Tongue carcinoma.
What makes this pain worse? (Triggers)
Now look, this pain can come from the things we normally do without thinking about anything.
If you experience pain while doing these activities, be aware of it and tell your doctor about it.
- Chewing food
- Coughing
- Drinking cold drinks
- The one who smiles
- The crocodile is going.
- Swallowing something (food or saliva)
- Talking
- Rubbing the face or neck around the ears
- Opening the door
Are there any serious side effects of GPN?
GPN usually does not cause serious complications, but if the pain is severe, the body may lose weight due to the fear of eating and drinking.
Very important: If GPN becomes severe, it can also affect the vagus nerve , which is located close to the glossopharyngeal nerve. This vagus nerve controls vital, automatic processes such as our heart rate, blood pressure, and breathing. If GPN also affects this nerve, the following serious conditions can occur:
- Irregular heartbeat (Arrhythmias)
- Slow heart rate (Bradycardia)
- Low blood pressure (Hypotension)
- Syncope
- Seizures
Although very rare, if this condition becomes severe, it can even lead to cardiac arrest. This is a very serious emergency. Therefore, if you experience pain along with nausea, seek medical advice immediately.
Doctor, how do you diagnose this?
Your doctor will first ask you about your symptoms and then perform a physical exam. Since GPN is a rare condition, it may take some time to find the exact cause.
The following tests can be done to confirm the diagnosis:
- Blood tests
- CT scan
- MRA scan
- MRI scan
- X-ray tests
The doctor may also do a simple test. He or she will gently touch the area where you are feeling pain with a small piece of cotton. Then, they will apply a local anesthetic to the area and do the same again. If the pain goes away after applying the medication, it is likely that it is GPN.
What are the treatments for GPN?
Fortunately, there are effective treatments to control GPN.
| Treatment method | Description |
|---|---|
| Medications | Medications that reduce the activity of nerve cells and control pain are given. Anticonvulsant medications such as Carbamazepine, Gabapentin, and Oxcarbazepine are the first to be used. |
| Local Anesthetic | A numbing medication like lidocaine can be sprayed or rubbed into the back of the throat to temporarily reduce pain. |
| Nerve Blocks | A drug is injected into the nerve near the source of the pain, stopping the pain signals from reaching the brain. |
| Surgery | If other treatments fail to control the pain, surgery may be considered. These include microvascular decompression or rhizotomy, which involves cutting the nerve fibers that transmit pain. |
Your doctor will talk to you and help you choose the treatment that best suits your condition.
When should I see a doctor?
If you have any of the pains described in this article in your face, mouth, or neck, you should definitely see a doctor. Although GPN is a rare condition, the nerves involved are located in a very important part of the head and neck. Therefore, finding the cause and treating it can help prevent dangerous conditions in the future.
When should I go to ETU?
GPN is not usually an emergency. However, as mentioned earlier, if you experience severe symptoms, you should go to the Emergency Department (ETU) immediately. Such symptoms include:
- Dizziness or loss of consciousness that occurs when opening a mouth or speaking.
- Loss of consciousness for no reason.
- Changes in heart rate (palpitations, irregular heartbeat).
Take-Home Message
- Glossopharyngeal Neuralgia (GPN) is a sudden, severe, electric-like pain in the throat, tongue, or ears. It can be triggered by simple things like eating or talking.
- This is caused by damage to the glossopharyngeal nerve. Often, the cause cannot be found.
- Even if this pain interferes with your life, don't panic. It can be well controlled with medications and other treatments. Don't suffer alone with the pain.
- If you experience nausea, dizziness, loss of consciousness, or changes in your heart rate along with the pain, it could be an emergency. Go to a hospital's Emergency Department (ETU) immediately.
- If you have symptoms like these, be sure to see your doctor for a proper diagnosis and treatment plan.
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