Reappraisal of glossopharyngeal neuralgia

Glossopharyngeal neuralgia is a rare disease characterized by severe paroxysmal attacks of pain in the distribution of the 9th cranial nerve. Glossopharyngeal neuralgia primarily can be caused by compression of the glossopharyngeal nerve, but in some cases, no cause is evident. Carbamazepine is the current drug of choice in therapy, but modern neurosurgical treatment will probably become more common in the future. Autonomic disturbances may occur during pain attacks in some patients. We describe a 42-year old Saudi male suffering from glossopharyngeal neuralgia with transitory unconsciousness due to cardiac asystole and arterial hypotension accompanying the attack of pain. We review pathogenesis, diagnosis, treatment and prognosis.