Glossopharyngeal neuralgia is a rare pain syndrome caused by compression of your glossopharyngeal nerve. It leads to episodes of severe pain, usually on one side of the back of your throat and nose.

The name “glossopharyngeal neuralgia” can be broken into three parts:

  • “Glosso” refers to your tongue.
  • “Pharyngeal” refers to your throat.
  • “Neuralgia” is pain caused by a damaged or irritated nerve.

Glossopharyngeal neuralgia causes brief episodes of pain that can last up to minutes and that may stop for days at a time. Medications such as carbamazepine or oxcarbazepine often help reduce the symptoms, but you may need surgery if your condition doesn’t respond to these medications.

In this article, we examine glossopharyngeal neuralgia in more detail, including its causes, symptoms, and treatment options.

Glossopharyngeal neuralgia is a pain syndrome caused by compression of your ninth cranial nerve, also known as the glossopharyngeal nerve. You have one of these nerves on each side of your head.

Glossopharyngeal neuralgia is extremely rare, making up only about 1.3% of neuralgias affecting cranial nerves. It’s thought to affect fewer than 1 in 100,000 people per year, and it seems to become more common with age.

Due to its rarity, doctors often misdiagnose glossopharyngeal neuralgia as a condition called trigeminal neuralgia, which is about 100 times more common.

The International Headache Society puts glossopharyngeal neuralgia into three subcategories:

  • classical: when it develops due to nerve compression and there’s no evidence of another underlying condition
  • secondary: when it’s caused by an underlying condition such as a tumor
  • idiopathic: when there’s no evidence of compression or an underlying condition

Your cranial nerves are 12 pairs of nerves that start in your brain. They have many functions, including helping you:

  • move structures in your face, like your tongue and eyes
  • taste, see, smell, and hear
  • feel your face
  • regulate your heart rate

Your ninth cranial nerve originates from a part of your brain called the medulla oblongata, and it ends near the back of your throat. It has many functions, such as:

  • providing feeling to:
    • your upper throat
    • your middle ear
    • the back third of your tongue
  • allowing you to taste with the back third of your tongue
  • decreasing saliva production
  • helping regulate blood pressure
  • controlling the stylopharyngeus muscle, which helps you swallow

Glossopharyngeal neuralgia can cause pain that lasts for a few seconds to up to 2 minutes at a time.

The pain starts suddenly, and it’s often severe along the parts of your head where sensory information is delivered by your glossopharyngeal nerve, such as:

  • the base of your tongue
  • the back and upper throat
  • your tonsils
  • your inner ear

Due to the proximity of the glossopharyngeal nerve to the vagus nerve, also called cranial nerve X, some people have additional symptoms. These may include:

Your pain needs to meet several diagnostic criteria for a doctor to make a glossopharyngeal neuralgia diagnosis. These are as follows:

  • reoccurring and sudden episodes of pain on at least one side of the head
  • pain that lasts from a few seconds to 2 minutes
  • pain that’s severe in intensity
  • electric shock-like, stabbing, or shooting pain
  • pain that occurs alongside swallowing, coughing, talking, or yawning
  • pain that’s not better explained by another headache disorder

The following activities may trigger pain in glossopharyngeal neuralgia:

  • coughing
  • talking
  • swallowing
  • yawning

In many cases, the underlying cause is unknown. In other cases, the condition can result from:

Glossopharyngeal neuralgia usually responds to medications, especially carbamazepine or oxcarbazepine.

Doctors often prescribe carbamazepine starting at 200 milligrams (mg) per day. They may increase the dosage as needed up to a maximum of 1,200 mg per day.

Other medications for treating glossopharyngeal neuralgia include:

  • baclofen
  • clonazepam
  • duloxetine
  • gabapentin
  • lamotrigine
  • phenytoin
  • pregabalin
  • topiramate
  • valproic acid

A doctor may suggest surgery if your condition doesn’t respond to medications. A procedure called microvascular decompression is the first-line surgical treatment. A surgeon can perform this minimally invasive procedure to relieve compression on the nerve by nearby blood vessels.

They may use a nerve block to help diagnose glossopharyngeal neuralgia and also help reduce pain. Pain reduction from the nerve block can indicate that glossopharyngeal neuralgia is the correct diagnosis.

Applying a local anesthetic to the tonsil and pharyngeal wall may also prevent pain for several hours.

It’s important to contact your doctor if you develop symptoms that may be due to glossopharyngeal neuralgia. Some of the underlying causes, such as tumors, require medical attention.

Your doctor can best advise if there’s anything you can do to reduce your symptoms after evaluating the underlying cause.

Some people have symptom relief with:

The outlook for glossopharyngeal neuralgia varies based on the severity of the symptoms. Only about a quarter of people need surgery. Less than a quarter of people have pain on both sides of their heads.

Glossopharyngeal neuralgia doesn’t usually affect life expectancy, but it can affect your quality of life if your pain is frequent and severe.

The following factors are associated with a lower quality of life:

  • pain on both sides of your head
  • severe pain
  • constant pain

When glossopharyngeal neuralgia occurs alongside vagus nerve symptoms, it’s called vagoglossopharyngeal neuralgia. Some people with this condition develop life threatening complications, such as cardiac arrest.

Glossopharyngeal neuralgia is a syndrome that can cause sudden episodes of pain in the area around the back of your throat and nose that last seconds to minutes. It’s caused by compression of the glossopharyngeal nerve.

Many people have symptom relief with medications. However, people whose condition doesn’t respond to medications may need surgery.