The disease to which this material will be devoted is not common. But at the same time, the symptoms of a lesion of the glossopharyngeal nerve appear very brightly, cause a lot of inconvenience to the patient. How to determine this disease, because of what it can occur, the article tells. She will also introduce the reader to the main diagnostic and therapeutic measures in this case.
What is this?
Symptoms of lesions of the glossopharyngeal nerve will be discussed further. First, let's define what kind of disease it is. This is the name of a unilateral lesion of the ninth cranial nerve. Characterized by pain in the root of the tongue, pharynx, soft palate, tonsils. Often she gives in the ear.
This pathology is known in medical circles as Sicard's syndrome. This is due to the fact that the disease was first described by Sicard in 1920.
General information
Symptoms of the glossopharyngeal nerve are quite unpleasant in their manifestations, worsen the patient's quality of life. This is a violation of the taste perception of the posterior third of the tongue, a decrease in the palatine and pharyngeal reflex, a violation of salivation.
Diagnostics of glossopharyngeal neuralgianerve is carried out by narrow specialists - a neurologist, dentist, otolaryngologist. Basically, a CT or MRI of the brain is performed. In some cases, echo-EG is indicated.
As for the treatment, in this case it is conservative. Anticonvulsant, pain medications are prescribed. Additionally, sedatives and hypnotics. As an auxiliary therapy, physiotherapy, vitamin complexes, general strengthening drugs can be used.
Medical statistics data
If we turn to medical statistics, we will find that glossopharyngeal neuralgia (symptoms and treatment of the disease will be described later) is a rather rare pathology. After all, it occurs in 16 people out of 10 million.
The main part of patients in this case are people over 40 years old. Mostly men.
Disease forms
Does it hurt to chew? This symptom can indicate both problems with the teeth and gums, and damage to the glossopharyngeal nerve. As for the last case, it is further divided into two forms:
- Primary. Or idiopathic.
- Secondary. Another name is symptomatic. It can develop with injuries, infectious processes that develop in the posterior cranial fossa. Or when tumors compress this nerve.
Causes of primary pathology
If the symptoms of glossopharyngeal nerve damage are similar in both forms of the disease, then their causes will be different.
In the primary form of Sicard's syndrome, neuralgia is idiopathic in nature. Therefore, it is not yet possible to establish its exact cause. However, it is believed that this form of glossopharyngeal nerve lesion can be triggered by the following:
- Atherosclerosis.
- Infections affecting the ENT organs. Somehow: tonsillitis, sinusitis, otitis media, chronic pharyngitis.
- Both acute and chronic intoxications of the body.
- Viral infectious diseases. A prime example is the flu.
Causes of secondary pathology
As for secondary neuralgia, then the causes can be established exactly. The most common are:
- Infectious pathology affecting the posterior cranial fossa. Arachnoiditis, encephalitis, etc.
- Various head injuries.
- Violation of the metabolic process. In particular, hyperthyroidism, diabetes mellitus.
- Irritation or squeezing of the nerve in any of the sections of its passage. In particular, this is universally observed in intracerebral tumors of the cerebellopontine angle. That is, with meningioma, glioma, hemangioblastoma, medulloblastoma. The cause may be intracerebral hematomas, hypertrophy of the styloid processes, nasopharyngeal tumors, aneurysms of the carotid artery, an increase in osteophytes of the jugular foramina, ossification of the stylohyoid ligament.
- Some experts believe that glossopharyngeal neuralgia is considered the first symptom of such dangerous conditions as cancer of the pharynx and larynx.
Symptomatics. How to recognize?
Determining the symptoms and treatment of glossopharyngeal neuralgia. The most common symptom is unilateral pain paroxysms, which can last from a few seconds to several minutes.
What does this mean? For example, the patient may feel that the soft palate hurts. If he follows his feelings, he will notice that the pain begins at the root of the tongue, after which it quickly radiates to the soft palate, tonsils, pharynx, and sometimes to the ear. Pain may also radiate to the lower jaw, neck, or eye.
Inflammation of the root of the tongue does not occur here. Although the symptoms are quite similar. Pain syndrome with neuralgia can provoke the following:
- Chewing.
- Swallowing.
- Yawn.
- Cough.
- Talk.
- Food too cold or too hot.
Remarkably, during an attack, patients report dry mouth, and after it - already increased salivation. With the same inflammation of the root of the tongue, this does not happen. It should be noted that dry mouth will not be a characteristic sign of such neuralgia, since the secretory insufficiency of the parotid salivary gland is often successfully compensated by the activity of neighboring glands.
As for swallowing disorders that can be caused by paresis of the levator pharynx muscle, they are not pronounced. It is explained by the fact that the role of this muscle in the act of swallowing is insignificant. But still, the patient may feel difficulty with chewing and further swallowing food. In this case, they are associated withsensitivity disorder. Including proprioceptive, which is responsible for the sensation of the position of the tongue in the mouth.
It is important to note that in some cases, the manifestation of the symptoms of neuralgia is associated with the seasons. So, it is most noticeable in the spring and autumn period.
Which specialist should I contact?
Neuralgia of the glossopharyngeal nerve is determined by a narrow specialist - a neurologist. But in order to exclude the possibility of diseases of the throat, nose, ear, oral cavity, an additional examination by a dentist and an otolaryngologist may be required.
Neurological diagnostics
During the examination, it is important for the doctor to determine analgesia (that is, the absence of pain sensitivity) in areas such as the base of the tongue, soft palate, tonsils and upper pharynx. Taste sensitivity is also tested. To do this, various flavoring solutions are applied to the symmetrical parts of the patient's tongue with a pipette.
In this case, it is the identification of a unilateral isolated disorder of taste perception in the posterior third of the tongue that is of great importance. After all, a bilateral violation of taste sensitivity indicates another pathology - diseases of the oral mucosa (for example, with a chronic form of stomatitis).
Next, the specialist checks the patient's pharyngeal reflex. Here the doctor lightly touches the back wall of the patient's throat with a paper tube. In response to this, swallowing movements should occur, and sometimes coughing, vomiting urges.
The palatine is also checkedreflex. Touching the instrument to the soft palate in a he althy person causes the palate and uvula to rise.
If all the above reactions are absent in a particular patient, the specialist has reason to suspect it is neuralgia of the glossopharyngeal nerve. But the absence of such reflexes can also indicate pathologies of the vagus nerve.
If during the examination of the pharynx and pharynx of the patient, rashes were found, this may indicate ganglionitis of the nodes of the glossopharyngeal nerve. The symptoms of this condition are very similar to the neuralgia we describe.
Instrumental diagnostics
To make a correct diagnosis, in addition to examination, the neurologist prescribes other diagnostic procedures to the patient. The most common today are magnetic resonance and computed tomography of the brain.
If it is not possible to conduct them, an echo-EG can be assigned. What it is? This is the abbreviation for echoencephalography. This is an ultrasound diagnostic neurophysiological method. First of all, it is valuable in that it helps to assess the presence of volumetric pathological processes occurring in the substance of the brain. An EEG and consultation with an ophthalmologist may also be prescribed. As part of the latter, ophthalmoscopy is mandatory - examination of the fundus.
A set of diagnostic procedures allows the specialist to verify the correctness of the diagnosis. And exclude the possibility of the patient developing the following pathologies:
- Ear node neuralgia.
- Trigeminal neuralgia.
- Glossalgia of a different etiology.
- Retropharyngeal abscess.
- Ganglionitis of the pterygopalatine node.
- Oppenheim Syndrome.
- Tumors of the pharynx and larynx.
Therapy directions
As we have already mentioned, the treatment of inflammation of the glossopharyngeal nerve is purely conservative. The only exceptions will be cases when it is squeezed. Here, surgical intervention is necessary to eliminate the compressive element. For example, resection of an enlarged styloid process.
To eliminate the pain syndrome that torments the patient, they turn to lubricating the root of the tongue and throat with a 10% cocaine solution. This method helps to stop pain for 6-7 hours. If the pain syndrome is persistent and intense, they turn to a more serious measure - the introduction of a 1-2% solution of novocaine. Moreover, the injection is made into the root of the tongue.
For oral administration, non-narcotic drugs can also be prescribed. In particular, ibuprofen, phenylbutazone, metamizole sodium, naproxen. In some cases, anticonvulsants are also indicated. The doctor may prescribe drugs with carbamazepine or phenytoin.
In the case when the pain syndrome with such neuralgia is pronounced, it torments the patient, the following medications will be shown:
- Sleeping pills.
- Antidepressants.
- Sedatives.
- Neuroleptic.
In some cases, the fastest recovery can be achieved by physiotherapyprocedures:
- SMT on the larynx and tonsils.
- Diadynamic therapy.
- Galvanization.
Vitamins B1, multivitamin and restorative preparations are prescribed as adjunctive therapy.
The prognosis of recovery in the case of glossopharyngeal neuralgia is estimated by experts as favorable. In cases where its cause is correctly identified, and later it is successfully removed or cured. But it should be noted that relief does not come here immediately. In some cases, several years of therapy is required.
