A 71-year-old woman attends your surgery complaining of a sharp pain which affects the back of her tongue and the area just beneath the angle of her jaw, always on the left-hand side alone. The pain lasts for about a minute and comes on when she swallows or chews. Her lower left first and second molar teeth are present and restored but they appear sound, are vital and are not tender to percussion.

While the tongue is commonly affected in burning mouth syndrome, the pain is of too short a duration and is described as sharp. The involvement of the area just below the angle of the jaw and pain on chewing might suggest dental pathology but the teeth are sound and not TTP. Similarly, were it not for the involvement of the tongue, a diagnosis of TN might be considered. However, taking into account the sites affected, the nature of the pain and when it is experienced, the diagnosis is glossopharyngeal neuralgia.

RESEARCH

Glossopharyngeal neuralgia is a rare condition that causes severe, stabbing pain in the throat, tongue, and ear. It happens because of a problem with a nerve called the glossopharyngeal nerve. This nerve is responsible for sending messages about feeling and pain from the throat and tongue to the brain. The exact cause of glossopharyngeal neuralgia is not fully understood, but it may be due to pressure on the nerve from blood vessels.

When someone has glossopharyngeal neuralgia, they experience sudden and intense pain attacks that can last for a short time. The pain can be triggered by things like swallowing, talking, or even just touching the affected area. It usually affects only one side of the face and can be very uncomfortable.

To diagnose glossopharyngeal neuralgia, doctors will ask about the person’s symptoms and do some tests. These tests may include imaging scans like an MRI to look for any problems with the nerve.

Treatment for glossopharyngeal neuralgia can involve medications to help manage the pain. Common medications include carbamazepine, oxcarbazepine, or gabapentin. In some cases, surgery may be necessary to relieve the pressure on the nerve. This can involve a procedure called microvascular decompression, where the blood vessels causing the compression are moved away from the nerve.

It’s important for dentists to be aware of glossopharyngeal neuralgia because it can cause neck pain that may be mistaken for dental problems. If a dentist suspects glossopharyngeal neuralgia, they will refer the patient to a specialist for further evaluation and treatment.

Overall, glossopharyngeal neuralgia is a rare condition that causes severe throat and ear pain. It can be diagnosed through medical tests and treated with medications or surgery. Dentists should be aware of this condition to provide appropriate referrals for their patients.

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