Glossopharyngeal and vagal neuralgia.

Chawla, Jitendra; Falconer, Murray A.

doi:10.1136/bmj.3.5564.529

Cited by 73 publications

(43 citation statements)

References 2 publications

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“…Most authors describe rhizotomy of the upper rootlets of cranial nerve X as benign, leading only to an irritative cough, foreign body sensation in the throat, and transient hoarseness or dysphagia. 8,31,54 Our review of the literature disclosed a 3-fold increase (18% vs 6%) in the risk of permanent postoperative cra nial nerve X dysfunction during rhizotomy versus MVD, respectively. The rate of pain control increases slightly (85% vs 96%) for MVD and cranial nerve X rhizotomy, respectively.…”

mentioning

confidence: 90%

Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery

Rey‐Dios

Cohen-Gadol

2013

FOC

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Glossopharyngeal neuralgia (GPN) is an uncommon facial pain syndrome often misdiagnosed as trigeminal neuralgia. The rarity of this condition and its overlap with other cranial nerve hyperactivity syndromes often leads to a significant delay in diagnosis. The surgical procedures with the highest rates of pain relief for GPN are rhizotomy and microvascular decompression (MVD) of cranial nerves IX and X. Neurovascular conflict at the level of the root exit zone of these cranial nerves is believed to be the cause of this pain syndrome in most cases. Vagus nerve rhizotomy is usually reserved for cases in which vascular conflict is not evident. A review of the literature reveals that although the addition of cranial nerve X rhizotomy may improve the chances of long-term pain control, this maneuver also increases the risk of permanent dysphagia and vocal cord paralysis. The risks of this procedure have to be carefully weighed against its benefits. Based on the authors' experience, careful patient selection with a thorough exploratory operation most often leads to identification of the site of vascular conflict, obviating the need for cranial nerve X rhizotomy.

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confidence: 90%

Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery

Rey‐Dios

Cohen-Gadol

2013

FOC

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“…Interruption of the glossopharyngeal nerve or the carotid sinus has been shown to be effective in preventing syncope from carotid sinus hypersensitivity (60,(67)(68)(69)(70)(71)(78)(79)(80)(81) and in controlling both pain and syncope from glossopharyngeal neuralgia (19,20,22,25,27,40,44,(72)(73)(74)(75)(76)(77). Although both extracranial and intracranial section (sometimes combined with section of the upper rootlets of the vagus) have been advocated and shown effective, in head and neck cancer patients the intracranial approach is preferred.…”

Section: Treatmentmentioning

confidence: 99%

Syncope from head and neck cancer

et al. 1983

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We have examined 17 patients suffering from recurrent syncope caused by carcinoma of the head and neck. The tumor originated in the mouth in seven, larynx in six, nasopharynx in three and parotid gland in one, and involved cervical lymph nodes at diagnosis in 12. Sixteen patients had previously had radical neck dissections and 12 had had radiation therapy. Recurrent carcinoma was present in 16. Spells resolved spontaneously in four, improved with treatment in 11 and continued in two. The syncope was spontaneous in 15 and induced only by suctioning or carotid sinus massage in two. Suctioning also produced attacks in four others, as did carotid sinus massage in five of ten tested. Acute severe unilateral head or neck pain preceded spontaneous syncope in 11. Sixteen patients had both profound bradycardia and hypotension during most spells, but ten had syncope with hypotension only, either spontaneously or following cardiac pacing or atropine to prevent bradycardia. Seizure activity accompanied syncope in eight. Anticholinergics improved 7/12, carbamazepine 2/5, carotid ligation 1/1 and intracranial sectioning of the glossopharyngeal nerve 1/1. Local radiation may have helped 4/10. Cardiac pacing was ineffective in 3/3 due to the development of pure vasodepressive syncope. Autopsy in 2/2 showed tumor involving the glossopharyngeal and vagus nerves. Syncope in these patients is under-recognized, frequently is due to vasodepression, and suggests recurrent carcinoma.

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“…The nerves of the lower group (the glossopharyngeal, vagus, accessory, and hypoglossal nerves) often come in contact with both the posterior surface of the vertebral artery and the jugular tubercle and then enter the jugular foramen. Despite this, arterynerve compression syndromes of these nerves rarely occur, with the exception of the glossopharyngeal neuralgia, or damage both of the glossopharyngeal nerve and cranial part of the vagus nerve (Chawla and Falconer, 1967).…”

Section: Discussionmentioning

confidence: 99%

Arterial relationships to the nerves and some rigid structures in the posterior cranial fossa

Surchev

2008

Clinical Anatomy

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The close relationships between the cranial nerves and the arterial vessels in the posterior cranial fossa are one of the predisposing factors for artery-nerve compression. The aim of this study was to examine the relationships of the vertebral and basilar arteries to some skull and dural structures and the nerves in the posterior cranial fossa. For this purpose, the skull bases and brains of 70 cadavers were studied. The topographic relationships of the vertebral and basilar arteries to the cranial nerves in the posterior cranial fossa were studied and the distances between the arteries and some osseous formations were measured. The most significant variations in arterial position were registered in the lower half of the basilar artery. Direct contact with an artery was established for the hypoglossal canal, jugular tubercle, and jugular foramen. The results reveal additional information about the relationships of the nerves and arteries to the skull and dural formations in the posterior cranial fossa. New quantitative information is given to illustrate them. The conditions for possible artery-nerve compression due to arterial dislocation are discussed and two groups (lines) of compression points are suggested. The medial line comprises of the brain stem points, usually the nerve root entry/exit zone. The lateral line includes the skull eminences, on which the nerves lie, or skull and dural foramina through which they exit the cranial cavity.

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Glossopharyngeal and vagal neuralgia.

Cited by 73 publications

References 2 publications

Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery

Current neurosurgical management of glossopharyngeal neuralgia and technical nuances for microvascular decompression surgery

Syncope from head and neck cancer

Arterial relationships to the nerves and some rigid structures in the posterior cranial fossa

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