Neuralgia of the Glossopharyngeal Nerve in a Patient with Posttonsillectomy Scarring: Recovery after Local Infiltration of Procaine—Case Report and Pathophysiologic Discussion

Abstract

We describe a patient with a three-year history of severe progressive left-sided glossopharyngeal neuralgia (GPN) that failed to adequately respond to various drug therapies. The application of lidocaine spray to the posterior pharyngeal wall provided no more than short-term relief. Apart from a large hypertrophic tonsillectomy scar on the left side all clinical and radiologic findings were normal. In terms of therapeutic local anaesthesia, the hypertrophic tonsillectomy scar tissue was completely infiltrated with the local anaesthetic (LA) procaine 1%. The patient has been almost completely pain-free ever since, and the lidocaine spray is no longer needed. Six weeks after the first treatment a repeat infiltration of the tonsillectomy scar led to the complete resolution of all symptoms. The patient has become totally symptom-free without the need to take any medication now for two and a half years. This is the first report of a successful therapeutic infiltration of a tonsillectomy scar using an LA in a patient with GPN that has been refractory to medical treatment for several years. A possible explanation may be that the positive feedback loop maintaining neurogenic inflammation is disrupted and “sympathetically maintained pain” resolved by LA infiltration.

Rapid resolution of concussion related symptoms in an 11‐month‐old male with integrative medicine assessment and treatment: Case report

“…It has been used for the treatment of multiple medical conditions, injuries, and pain. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] The IF concept was developed to explain some of the of the NT effects. Scars, fractures, dental lesions can create ANS disturbances that can affect other organs.…”

“…Over the past 90 years, reports have documented clinical experience suggesting that injecting an IF such as a scar or cutaneous segment overlying the location of the IF can resolve pain, organ dysfunction, or other symptoms near or at a distance from the IF. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Local anesthetic injections, like procaine, have the capacity to repolarize the nerve cell membrane resulting in restoration of organ function. 12 Nerve cell polarization is posited to be the crucial NT mechanism 12 in contrast to endorphin release in acupuncture.…”

“…It is commonly used in German‐and Spanish‐speaking countries, but poorly known in the English‐speaking world. It has been used for the treatment of multiple medical conditions, injuries, and pain …”

“…Signals from IFs can provide nonanatomically connected interference with body areas and organs remote from the damaged tissue Approved producing the IF. Over the past 90 years, reports have documented clinical experience suggesting that injecting an IF such as a scar or cutaneous segment overlying the location of the IF can resolve pain, organ dysfunction, or other symptoms near or at a distance from the IF …”

Neural Therapy Protocols in Musculoskeletal Disorders: Review

“…Bozucu alanlardan çıkan anormal elektriksel deşarjlar nörovejetatif sistemi bozarak hastalıklara sebep olabilir. Bu sebeple lokal ve segmental tedaviye yeterince yanıt alınamadığında vücuttaki bozucu alanlar araştırılmalı ve bu alanlara lokal anestezik enjeksiyonları uygulanarak anormal elektriksel deşarj alanlarından gelen bu uyarılar elimine edilmelidir (Resim 3) (11)(12)(13)(14).…”