Glossopharyngeal neuralgia: neurosurgical treatment and differential diagnosis.

The objective of this study was to review the literature on glossopharyngeal neuralgia (GN) and to discuss its differential diagnosis and treatment options. Despite the significant improvement of trigeminal neuralgia with pharmacological treatment, GN has a higher incidence of treatment failure and neurosurgery is necessary for the majority of patients. Functional neurosurgery has a great rate of success for GN, especially techniques such as percutaneous thermal rhizotomy, trigeminal tractotomy and/or nucleotomy. The main problem with GN remains the diagnosis as it is a rare disease with similarities to trigeminal neuralgia, including the same pharmacological treatment. Facial pain specialists should be trained to achieve a better accuracy of diagnosis.

Glossopharyngeal neuralgia.

Glossopharyngeal neuralgia is a distinctive syndrome, named by Wilfred Harris. Investigation must exclude multiple sclerosis, and local compression, especially by tumours which require treatment. Dandy deserves credit for first indicating vascular compression of cranial nerve roots as a cause of cranial neuralgias, and Jannetta for establishing neurovascular decompression. Vascular compression is a common and treatable cause but does not account for all previously designated idiopathic cases.