Glossopharyngeal nerve. The glossopharyngeal nerve and what diseases occur with it. Drug treatment of the disease

Neuralgia of the glossopharyngeal nerve is a disease characterized by unilateral non-inflammatory damage to the IX pair of cranial nerves. Its symptoms are similar to those of trigeminal neuralgia, and therefore there is a high probability of errors in making a diagnosis. However, this pathology develops much less frequently than the latter: it affects 1 person per 200 thousand population, for 1 case of glossopharyngeal neuralgia there are about 70-100 nerve lesions. It affects mature and elderly people, mainly men.

From our article you will learn about why this disease occurs, what its clinical manifestations are, as well as the principles of diagnosis and treatment of glossopharyngeal neuralgia. But first, so that the reader understands why certain symptoms occur, we will briefly look at the anatomy and functions of the IX pair of cranial nerves.

Anatomy and function of the nerve

As mentioned above, the term “glossopharyngeal nerve” (in Latin – nervus glossopharyngeus) refers to the IX pair of cranial nerves. There are two of them, left and right. Each nerve consists of motor, sensory and parasympathetic fibers, which originate in the nuclei of the medulla oblongata.

Its motor fibers provide movement of the stylopharyngeal muscle, which elevates the pharynx.
Sensitive fibers extend to the mucous membrane of the tonsils, pharynx, soft palate, tympanic cavity, auditory tube and tongue and provide sensitivity to these areas. Its taste fibers, being a type of sensory fibers, are responsible for the taste sensations of the posterior third of the tongue and the epiglottis.
Together, the sensory and motor fibers of the glossopharyngeal nerve form the reflex arcs of the pharyngeal and palatal reflexes.
Parasympathetic autonomic fibers of this nerve regulate the functions of the parotid gland (responsible for salivation).

It is important to know that the glossopharyngeal nerve passes in close proximity to the vagus nerve; therefore, in many cases, their combined lesion is determined.

Etiology (causes) of glossopharyngeal nerve neuralgia

Depending on the causative factor, two forms of this pathology are distinguished: primary (or idiopathic, since its cause cannot be reliably determined) and secondary (otherwise, symptomatic).

In most cases, neuralgia of the glossopharyngeal nerve occurs in the following situations:

lesions of the posterior cranial fossa (this is where the medulla oblongata is localized) of an infectious nature - arachnoiditis, and others;
diseases of the endocrine system (diabetes, etc.);
in case of irritation or compression of the nerve directly in any part of it, most often in the medulla oblongata (with tumors - meningioma, hemangioblastoma, cancer in the nasopharynx and others, hemorrhages in the brain tissue, carotid artery aneurysm, hypertrophy of the styloid process and a number of others situations);
in case of malignant neoplasms of the pharynx or larynx.

Also, risk factors for the development of this disease are acute viral (in particular, influenza), acute and chronic bacterial (tonsillitis, pharyngitis, otitis, sinusitis and others) infections and atherosclerosis.

Clinical manifestations

This pathology occurs in the form of acute attacks of pain, which originates at the root of the tongue or one of the tonsils, and then spreads to the soft palate, pharynx and ear structures. In some cases, pain can radiate to the eye area, the angle of the lower jaw, and even to the neck. The pain is always one-sided.

Such attacks last for 1-3 minutes, they are provoked by movements of the tongue (during eating, loud conversation), irritation of the tonsil or the root of the tongue.

Patients are often forced to sleep exclusively on the healthy side, since in the lying position on the affected side, saliva flows, and the patient is forced to swallow it in his sleep, and this provokes night attacks of neuralgia.

In addition to pain, a person is worried about dry mouth, and at the end of the attack, the release of a large amount of saliva (hypersalivation), which, however, is less on the affected side than on the healthy side. In addition, the saliva secreted by the affected gland is characterized by increased viscosity.

Some patients may experience the following symptoms during a painful attack:

darkening of the eyes;
decreased blood pressure;
loss of consciousness.

Most likely, such manifestations of the disease are associated with irritation of one of the branches of the glossopharyngeal nerve, which leads to inhibition of the vasomotor center in the brain, and consequently to a drop in pressure.

Neuralgia occurs with alternating periods of exacerbations and remissions, the duration of the latter in some cases being up to 12 months or more. However, over time, attacks occur more frequently, remissions become shorter and shorter, and the pain becomes more intense. In some cases, the pain is so severe that the patient groans or screams, opens his mouth wide and actively rubs his neck at the angle of the lower jaw (under the soft tissues of this area is the pharynx, which, in fact, hurts).

Patients with experience often complain of pain that is not periodic, but constant, which becomes stronger when chewing, swallowing, and talking. They may also have a disturbance (decrease) in sensitivity in areas innervated by the glossopharyngeal nerve: in the posterior third of the tongue, tonsil, pharynx, soft palate and ear, impaired taste in the root of the tongue, and a decrease in the amount of saliva. With symptomatic neuralgia, sensitivity disorders progress over time.

The consequence of sensory disturbances in some cases is difficulty chewing food and swallowing it.

Diagnostic principles

The primary diagnosis of neuralgia of the glossopharyngeal nerve is based on the doctor’s collection of the patient’s complaints, data from his life history and current illness. Everything matters: the location, the nature of the pain, when it occurs, how long the attack lasts and how the attack ends, how the patient feels during the period between attacks, other symptoms that bother the patient (they may indicate pathology - a potential cause of neuralgia), concomitant neurological diseases , endocrine, infectious or other nature.

Then the doctor will conduct an objective examination of the patient, during which he will not reveal any significant changes in his condition. Unless pain may be detected when palpating the soft tissues above the angle of the lower jaw and in certain areas of the external auditory canal. Often in such patients, the pharyngeal and palatal reflexes are reduced, the mobility of the soft palate is impaired, and sensitivity disorders in the posterior third of the tongue are determined (the patient perceives all tastes as bitter). All changes are not bilateral, but are detected only on one side.

To determine the causes of secondary neuralgia, the doctor will refer the patient for further examination, which will include some of these methods:

echoencephalography;
computer or magnetic resonance imaging of the brain;
consultation of related specialists (in particular, an ophthalmologist, with a mandatory examination of the fundus - ophthalmoscopy).

Differential diagnosis

Some diseases occur with symptoms similar to those of glossopharyngeal neuralgia. In each case when a patient presents with such symptoms, the doctor conducts a thorough differential diagnosis, because the nature of these pathologies is different, which means that the treatment has its own characteristics. So, pain attacks in the facial area are accompanied by the following diseases:

trigeminal neuralgia (much more common than others);
ganglionitis (inflammation of the nerve ganglion) of the pterygopalatine ganglion;
neuralgia of the ear ganglion;
various natures of glossalgia (pain in the tongue);
Oppenheim syndrome;
neoplasms in the pharynx;
retropharyngeal abscess.

Treatment tactics

As a rule, neuralgia of the glossopharyngeal nerve is treated conservatively, combining the patient's medication and physiotherapy procedures. Sometimes it is not possible to do without surgery.

Drug treatment

The leading goal of treatment in this situation is the elimination or at least significant relief of pain that causes suffering to the patient. For this use:

local anesthetic preparations (dicaine, lidocaine) on the root of the tongue;
injection drugs of local anesthesia (Novocaine) – when topical agents do not have the desired effect; the injection is carried out directly into the root of the tongue;
non-narcotic analgesics (non-steroidal anti-inflammatory drugs) for oral or injection use: ibuprofen, diclofenac and others.

The patient may also be prescribed:

B vitamins (milgamma, neurobion and others) in the form of tablets and solution for injection;
(finlepsin, diphenin, carbamazepine and so on) in tablets;
(in particular, aminazine) for injection;
multivitamin complexes (Complivit and others);
drugs that stimulate the body's defenses (ATP, FiBS, ginseng preparations and others).

Physiotherapy

Physiotherapy techniques play an important role in the complex treatment of glossopharyngeal nerve neuralgia. They are carried out for the purpose of:

reduce the intensity of pain attacks and their frequency;
improve blood flow in the affected area;
improve tissue nutrition in areas innervated by this nerve.

The patient is prescribed:

fluctuating currents to the upper sympathetic nodes (more precisely, to the area of their projection); the first electrode is placed 2 cm back from the angle of the lower jaw, the second – 2 cm above this anatomical formation; apply current until the patient feels moderate vibration; the duration of such exposure is usually from 5 to 8 minutes; procedures are carried out every day in a course of 8-10 sessions; the course of treatment is repeated 2-3 times every 2-3 weeks;
sinusoidal modulated currents to the area of projection of the cervical sympathetic nodes (an indifferent electrode is placed on the back of the patient’s head, and bifurcated electrodes are placed on the sternocleidomastoid muscles; the session lasts 8-10 minutes, procedures are carried out once a day, with a course of up to 10 impacts, which is repeated three times with an interval of 2 -3 weeks);
ultrasound therapy or ultraphonophoresis of painkillers (in particular, analgin, anestezin) drugs or aminophylline; affect the occipital region, on both sides of the spine; The session lasts 10 minutes, they are carried out once every 1-2 days in a course of 10 procedures;
drug electrophoresis of ganglerone paravertebral to the cervical and upper thoracic vertebrae; session duration is from 10 to 15 minutes, they are repeated daily, in a course of 10-15 impacts;
magnetotherapy with alternating magnetic field; the “Polyus-1” apparatus is used, influencing the vertebrae of the cervical and upper thoracic spine through a rectangular inductor; session duration is 15-25 minutes, they are carried out once a day in a course of 10 to 20 procedures;
decimeter wave therapy (it is applied to the patient’s collar area using a rectangular emitter of the “Volna-2” device; the air gap is 3-4 cm; the procedure lasts up to 10 minutes, they are repeated once every 1-2 days for a course of 12-15 sessions);
laser puncture (impact on biological points of the IX pair of cranial nerves, exposure is up to 5 minutes per 1 point, procedures are carried out every day in a course of 10 to 15 sessions);
therapeutic massage of the cervical-collar area (performed daily, the course of treatment includes 10-12 procedures).

Surgery

In some situations, in particular with hypertrophy of the styloid process, surgical intervention involving resection of part of this anatomical formation cannot be avoided. The purpose of the operation is to eliminate external compression of the nerve or irritation by surrounding tissues.

Conclusion

Neuralgia of the glossopharyngeal nerve, although it occurs quite rarely, can cause real suffering to the person suffering from it. The disease can be idiopathic (primary) or symptomatic (secondary). It manifests itself as attacks of pain in the areas of innervation of the IX pair of cranial nerves, and a pre-fainting state. It occurs with alternating exacerbations and remissions, but over time, attacks occur more often, pain becomes more intense, and remissions become shorter and shorter. It is important to correctly diagnose this pathology, since in some cases it is a manifestation of serious diseases that require urgent treatment.

Treatment of neuralgia itself may include the patient taking medications, physical therapy, or surgery (which, fortunately, is relatively rarely necessary).

The prognosis for recovery from this pathology is usually favorable. However, its treatment is long-term and persistent: it lasts up to 2-3 years and even longer.

Channel One, program “Live Healthy” with Elena Malysheva, section “About Medicine” on the topic “Neuralgia of the glossopharyngeal nerve”:

Unilateral damage to the IX cranial nerve, manifested by paroxysms of pain in the root of the tongue, tonsils, pharynx, soft palate and ear. Accompanied by impaired taste perception of the posterior 1/3 of the tongue on the affected side, impaired salivation, decreased pharyngeal and palatal reflexes. Diagnosis of pathology includes examination by a neurologist, otolaryngologist and dentist, an MRI or CT scan of the brain. Treatment is mainly conservative, consisting of analgesics, anticonvulsants, sedative and hypnotic medications, vitamins and restoratives, and physiotherapeutic techniques.

General information

Neuralgia of the glossopharyngeal nerve is a fairly rare disease. There are approximately 16 cases per 10 million people. People usually suffer after the age of 40, men more often than women. The first description of the disease was given in 1920 by Sicard, and therefore the pathology is also known as Sicard syndrome.

Secondary neuralgia of the glossopharyngeal nerve can occur with infectious pathology of the posterior cranial fossa (encephalitis, arachnoiditis), traumatic brain injury, metabolic disorders (diabetes mellitus, hyperthyroidism) and compression (irritation) of the nerve along any part of its passage. The latter is possible with intracerebral tumors of the cerebellopontine angle (glioma, meningioma, medulloblastoma, hemangioblastoma), intracerebral hematomas, nasopharyngeal tumors, hypertrophy of the styloid process, aneurysm of the carotid artery, ossification of the stylohyoid ligament, proliferation of osteophytes of the jugular foramen. A number of clinicians say that in some cases, neuralgia of the glossopharyngeal nerve may be the first symptom of laryngeal or pharynx cancer.

Symptoms

Neuralgia of the glossopharyngeal nerve is clinically manifested by unilateral painful paroxysms, the duration of which varies from a few seconds to 1-3 minutes. Intense pain begins at the root of the tongue and quickly spreads to the soft palate, tonsils, pharynx and ear. Irradiation to the lower jaw, eye and neck is possible. Painful paroxysm can be provoked by chewing, coughing, swallowing, yawning, eating excessively hot or cold food, or normal conversation. During an attack, patients usually feel a dry throat, and after it - increased salivation. However, dry throat is not a constant sign of the disease, since in many patients the secretory insufficiency of the parotid gland is successfully compensated by other salivary glands.

Swallowing disorders associated with paresis of the levator pharyngeal muscle are not clinically expressed, since the role of this muscle in the act of swallowing is insignificant. Along with this, difficulties in swallowing and chewing food may be observed, associated with a violation of various types of sensitivity, including proprioceptive - responsible for sensing the position of the tongue in the oral cavity.

Often, neuralgia of the glossopharyngeal nerve has a wave-like course with exacerbations in the autumn and winter periods of the year.

Diagnostics

Neuralgia of the glossopharyngeal nerve is diagnosed by a neurologist, although consultation with a dentist and otolaryngologist, respectively, is required to exclude diseases of the oral cavity, ear and throat. A neurological examination reveals the absence of pain sensitivity (analgesia) in the area of the base of the tongue, soft palate, tonsils, and upper parts of the pharynx. A test of taste sensitivity is carried out, during which a special taste solution is applied to symmetrical areas of the tongue with a pipette. It is important to identify an isolated unilateral disorder of taste sensitivity of the posterior 1/3 of the tongue, since a bilateral taste disorder can be observed in pathology of the oral mucosa (for example, in chronic stomatitis).

The pharyngeal reflex is checked (the occurrence of swallowing, sometimes coughing or vomiting movements, in response to touching the back wall of the pharynx with a paper tube) and the palatine reflex (touching the soft palate is accompanied by raising the palate and its uvula). The unilateral absence of these reflexes speaks in favor of damage to n. glossopharyngeus, however, it can also be observed with pathology of the vagus nerve. During examination of the pharynx and pharynx, detection of rashes typical of a herpetic infection suggests ganglionitis of the nodes of the glossopharyngeal nerve, which has symptoms almost identical to neuritis of the glossopharyngeal nerve.

In order to establish the cause of secondary neuritis, they resort to neuroimaging diagnostics -

The glossopharyngeal nerve is mixed. It contains motor and sensory fibers for the pharynx and middle ear, as well as gustatory fibers and autonomic parasympathetic fibers.

Motor pathway IX pairs two-neuron. The central neurons are located in the lower parts of the anterior central gyrus, their axons as part of the corticonuclear pathway approach the double nucleus (n. ambiguus) of their own and the opposite side, common with the X pair, where the peripheral neuron is located. Its axons, as part of the glossopharyngeal nerve, innervate the stylopharyngeal muscle, which elevates the upper part of the pharynx during swallowing.

Sensitive part The nerve is divided into general and gustatory. Sensory pathways consist of three neurons. The first neurons are located in the cells of the superior node, located in the region of the jugular foramen. The dendrites of these cells are directed to the periphery, where they innervate the posterior third of the tongue, soft palate, pharynx, pharynx, anterior surface of the epiglottis, auditory tube and tympanic cavity. The axons of the first neuron end in the nucleus of the gray wing (n. alae cinereae), where the second neuron is located. The core is common with the X pair. The third neurons for all types of sensitivity are located in the nuclei of the thalamus, the axons of which, passing through the internal capsule, go to the lower part of the posterior central gyrus.

Taste sensitivity. The taste sensitivity pathways are also three-neuron. The first neurons are located in the cells of the inferior ganglion, whose dendrites provide taste to the posterior third of the tongue. The second neuron is located in the nucleus of the solitary tract in the medulla oblongata, common with the facial nerve of both its own and the opposite side. Third neurons are located in the ventral and medial nuclei of the thalamus. The axons of the third neurons end in the cortical sections of the taste analyzer: the mediobasal sections of the temporal lobe (insula, hippocampal gyrus).

Parasympathetic autonomic fibers begin in the lower salivary nuclei (n. salivatorius inferior), located in the medulla oblongata and receiving central innervation from the anterior parts of the hypothalamus. Preganglionic fibers first follow as part of the glossopharyngeal nerve, pass through the jugular foramen and then enter the tympanic nerve, forming the tympanic plexus in the tympanic cavity, exit the tympanic cavity under the name of the small petrosal nerve (n. petrosus superficialis minor) and enter the ear node, where and end. Postganglionic salivary fibers of the cells of the auricular ganglion join the auriculotemporal nerve and innervate the parotid salivary gland.

Research methodology

The study of the function of the glossopharyngeal nerve is carried out in conjunction with the study of the function of the vagus nerve (see below).

Symptoms of the lesion

There may be a taste disorder in the posterior third of the tongue (hypogeusia or ageusia), decreased sensitivity in the upper half of the pharynx, and decreased pharyngeal and palatal reflexes on the affected side.

Irritation of the glossopharyngeal nerve is manifested by pain in the root of the tongue, tonsil, radiating to the throat, velum, soft palate, ear (occurs with neuralgia of the glossopharyngeal nerve).

X pair - vagus nerve (n. vagus)

The vagus nerve is mixed, containing motor, sensory and autonomic fibers.

Engine part The vagus nerve consists of two neurons. The central neurons are located in the lower parts of the anterior central gyrus, the axons of which go to the double nucleus of both sides, common with the glossopharyngeal nerve. Peripheral motor fibers in the vagus nerve exit through the jugular foramen and then are directed to the striated muscles of the pharynx, soft palate, uvula, larynx, epiglottis and upper esophagus.

Sensitive part The vagus nerve system, like all sensory pathways, consists of three neurons. The first neurons of general sensitivity are located in two nodes: in the upper node, located in the jugular foramen, and the lower node, located after the seal exits the jugular foramen. The dendrites of these cells form the peripheral sensory fibers of the vagus nerve. The first branch to form is to the dura mater of the posterior cranial fossa.

Fibers from top node innervate the skin of the posterior wall of the external auditory canal, and also anastomose with the posterior auricular nerve (branch of the facial nerve). The dendrites of the cells of the lower node, connecting with the branches of the glossopharyngeal nerve, form the pharyngeal plexus, from which branches extend to the mucous membrane of the pharynx.

Fibers from bottom node They also form the superior laryngeal and recurrent laryngeal nerves, innervating the larynx, epiglottis and partly the root of the tongue. Fibers are also formed from the lower node, providing general sensitivity to the trachea and internal organs.

The axons of the cells of the upper and lower nodes enter the cranial cavity through the jugular foramen, penetrate into the medulla oblongata into the nucleus of general sensitivity (nucleus of the gray wing), common with the IX pair (second neuron). The axons of the second neuron are directed to the thalamus (third neuron), the axons of the third neuron end in the cortical sensitive area - the lower parts of the postcentral gyrus.

Vegetative parasympathetic fibers start from the posterior nucleus of the vagus nerve (n. dorsalis n. vagi) and innervate the heart muscle, smooth muscles of the internal organs, interrupting in the intramural ganglia and, to a lesser extent, in the cells of the plexuses of the thoracic and abdominal cavities. The central connections of the posterior nucleus of the vagus nerve come from the anterior nuclei of the hypothalamic region. The function of the parasympathetic fibers of the vagus nerve is manifested in a slowdown in cardiac activity, narrowing of the bronchi, and increased activity of the gastrointestinal tract.

Research methodology

IX - X pairs are studied simultaneously. The patient's voice, the purity of pronunciation of sounds, the condition of the soft palate, swallowing, the pharyngeal reflex and the soft palate reflex are examined. It should be borne in mind that a bilateral decrease in the pharyngeal reflex and the soft palate reflex can also occur normally. Their decrease or absence on one side is an indicator of damage to the IX - X cranial nerves. The swallowing function is checked by swallowing water, the taste on the back third of the tongue is examined for bitter and salty (function of the IX pair). Laryngoscopy is performed to examine the function of the vocal cords. The pulse, breathing, and activity of the gastrointestinal tract are checked.

Symptoms of the lesion

When the vagus nerve is damaged due to paralysis of the muscles of the pharynx and esophagus, swallowing is impaired (dysphagia), which is manifested by choking while eating and the entry of liquid food into the nose through the nasal part of the pharynx as a result of paralysis of the palatine muscles. The examination reveals a write-off of the soft palate on the affected side. The pharyngeal reflex and the reflex from the soft palate decrease, the uvula deviates to the healthy side.

With unilateral damage to the medulla oblongata in the region of the nuclei of the IX and X cranial nerves, alternating syndromes:

- Wallenberg - Zakharchenko - on the affected side there is paralysis (paresis) of the soft palate and vocal cord, a sensitivity disorder in the pharynx, larynx and on the face of a segmental type, Bernard-Horner syndrome, nystagmus, ataxia, on the opposite side - hemianesthesia, less often hemiplegia. With extensive lesions involving the reticular formation surrounding the cranial nerves, respiratory and cardiovascular disorders are also observed;

- Avellisa - on the affected side - peripheral paralysis of the IX and X nerves, on the opposite side - hemiplegia or hemiparesis.

Symptoms of damage to the vagus nerve include respiratory, gastrointestinal and, more often, cardiac problems:

Tachycardia is detected when its functions are lost and, conversely, bradycardia is detected when it is irritated. With unilateral lesions, the described symptoms may be mild.

Bilateral damage to the vagus nerve leads to severe disturbances in breathing, cardiac activity, swallowing, and phonation. When the sensory branches of the vagus nerve are involved, a disorder of the sensitivity of the mucous membrane of the larynx, pain in it and the ear occurs. Complete bilateral damage to the vagus nerves leads to cardiac and respiratory arrest.

Glossopharyngeal nerve (IX pair) - mixed. It contains somatic motor fibers, fibers of general and taste sensitivity, as well as parasympathetic secretory fibers. Therefore, the glossopharyngeal nerve has four nuclei - the motor double nucleus (nucl. ambiguus) and the nucleus of general types of sensitivity (nucl. alae cinerea), common with the vagus nerve, as well as the taste nucleus (nucl. tractus solitarius), common with the intermediate nerve and the lower salivary nucleus (nucl. salivatorius inferior). The nerve root exits in the region of the posterior lateral sulcus of the medulla oblongata behind the olive, and through the jugular foramen the nerve leaves the cranial cavity.

The motor fibers of the nerve innervate only one muscle of the pharynx, the stylopharyngeus. Sensitive fibers of the nerve begin from the cells of the upper (gangl. superius) and lower (gangl. inferius) nodes located near the jugular foramen. The dendrites of these cells perceive irritations from the posterior third of the tongue, soft palate, pharynx, pharynx, anterior surface of the epiglottis, as well as the auditory tube and tympanic cavity. Taste fibers perceive predominantly bitter and salty taste stimuli from the posterior third of the tongue. The axons of the sensory cells of the nodes enter the medulla oblongata, where they end in the corresponding nuclei. alae cinerea and nucl. tractus solitarius. The fibers of the second sensory neurons located in the nuclei carry out a partial decussation and, joining the medial loop, are sent to the thalamus, where they switch to third neurons. The axons of third neurons in the thalamo-cortical pathway are directed to the sensitive projection zones of the cerebral cortex. Parasympathetic secretory nerve fibers from the inferior salivary nucleus switch in the ear ganglion (gangl. oticum) and, joining the auriculotemporal nerve (a branch of the trigeminal nerve), reach the parotid salivary gland.

Pathology. When the glossopharyngeal nerve is damaged, the perception of predominantly bitter taste (hypo- or ageusia) on the posterior third of the tongue for its part is impaired, swallowing is somewhat impaired and anesthesia of pain, tactile and temperature sensitivity occurs in the area of innervation of the nerve. Dryness in the mouth due to loss of function of one parotid gland is observed infrequently, since other salivary glands are functioning. Irritation of the sensory nerve fibers causes neuralgia with attacks of unilateral pain in the area of the root of the tongue, palatine tonsil, soft palate, pharynx, ear, occurring during swallowing, intensive chewing, and talking. Isolated damage to the glossopharyngeal nerve leads to a decrease in the pharyngeal and palatal reflexes due to partial damage to their reflex arc.

The glossopharyngeal nerve is part of the IX pair of all nerves of the skull. Has several different types of fibers. In the article we will consider its functions, structure, as well as common diseases. It is necessary to understand why it is needed and how to deal with neuralgia.

Anatomy

The described nerve leaves the brain near the tenth and eleventh. As a result, they unite into a single whole and leave the skull together. The tympanic nerve branches off at this point. Here the glossopharyngeal nerve is divided into a superior and inferior ganglion. They contain special neural impulses that a person needs for sensitivity. After this, the nerve bends around the carotid artery and passes to the carotid sinus. Then it moves to the pharynx, where branching occurs. As a result, several branches appear. They are divided into pharyngeal, almond, and lingual.

Functions

The glossopharyngeal nerve consists of two: right and left. Each of them has special fibers that are responsible for specific functions. Motor functions are necessary for a person to be able to lift the throat. Sensitive ones refer to the mucous membrane of the tonsils, they pass through the larynx, oral cavity, and also affect the ears. Thanks to them, the sensing of these zones is ensured. Flavor fibers are directly responsible for the sensation of taste. Due to the glossopharyngeal nerve, reflexes of the palatine region are formed. Due to parasympathetic fibers, the gland responsible for salivation functions correctly in humans.

Causes of neuralgia

This pathology is divided into two types: primary and secondary. There is also idiopathic. Its cause is difficult and sometimes impossible to find out. Most often, neuralgia of the glossopharyngeal nerve occurs due to the fact that a person has diseases of the endocrine system. Pathology may also be associated with malignant formations in the larynx, irritation of a certain nerve by foreign substances, especially if it is located in the medulla oblongata. TBI can also be a provoking factor. Other causes of neuralgia include bacterial infection, atherosclerosis and viral diseases.

Symptoms

This pathology is manifested by severe pain, which can be localized at the root of the tongue or on the tonsils. Further, as soon as the disease begins to progress, discomfort will spread to the ear and throat. They can also spread to the eyes, neck or even jaw. Unilateral pain. Such an attack can last no more than 5 minutes. It is usually provoked by various movements of the tongue, for example, talking or eating.

Often, pain with damage to the glossopharyngeal nerve can occur due to irritation of the tonsils. Patients have to sleep only on one side, as when saliva flows, there is a desire to swallow it. Accordingly, pain is provoked. Thirst, dry mouth, and increased salivation may also occur. However, the latter, as a rule, is recorded on the healthy side, and not on the one that was affected by neuralgia. The saliva secreted during this disease has increased viscosity.

Some patients may experience symptoms such as severe dizziness, decreased blood pressure, fainting, and darkening of the eyes. Neuralgia has periods of remission and exacerbation. Sometimes the period of rest can be even a year or more. However, after a certain time, the attacks increase in duration, they become more frequent and intense. The pain increases. The patient may moan and scream from discomfort, and also rub his neck under the lower jaw. All patients who have had neuralgia for quite some time may complain of constant pain. At the same time, it will become stronger during various manipulations with the tongue, that is, when chewing and so on.

Diagnostics

The initial diagnosis of problems with the glossopharyngeal nerve involves taking a medical history. In this case, almost all factors matter, that is, the type of pain, where it is localized, how long it lasts, how the attacks end, what other additional symptoms bother the patient. Concomitant diseases associated with the endocrine system, as well as some infectious and neurological diseases, may occur.

Next, an external examination is carried out, during which most likely no significant changes will be noticed. Sometimes pain is felt on palpation in the lower jaw area. Patients may have a noticeably reduced pharyngeal reflex, and a problem with the mobility of the soft palate. Moreover, all these changes occur only on one side.

In order to understand the causes of secondary neuralgia of the glossopharyngeal nerve, the symptoms of which are similar to those described above, it is necessary to send the patient for additional examination. We are talking about consultation with some specialists, including an ophthalmologist. Tomography, echoencephalography, and other similar procedures are prescribed.

Drug treatment of the disease

Often, immediately during the examination, doctors prescribe special medications. They will minimize pain. These may be drugs that are local anesthetics. They act on the root of the tongue, freezing the glossopharyngeal nerve. An example would be Lidocaine.

Injectable drugs that are prescribed if the first type of drugs do not have the desired effect help a lot.

Non-steroidal anti-inflammatory drugs are prescribed as a last resort. Typically, they can be either in the form of tablets or injections.

Patients are also prescribed vitamins, anticonvulsants, antipsychotics, as well as drugs that activate the immune system.

Surgery

If a person has an extremely critical situation, surgery may be prescribed. The operation will be aimed at eliminating the causes of compression of the nerve, as well as its irritation. Often it is carried out without complications. However, this procedure is used as a last resort for treatment. The glossopharyngeal nerve in case of neuralgia should be restored immediately at the first symptom.

Results

The article examined many aspects that relate to the described nerve. It is important to understand why it is needed and how to distinguish serious problems. The symptoms are quite noticeable, so you should consult a doctor immediately. Neuralgia of the glossopharyngeal nerve is quite rare, but it causes severe inconvenience to a person. There are primary and secondary. As mentioned above, the pathology is manifested by fainting and attacks of pain. There are periods of remission and exacerbation, and attacks occur more frequently and more intensely over time.

In order to cure the disease in time, it is necessary to diagnose it correctly and quickly. This disease should be treated immediately when the first symptoms appear. Therapy may include medications, physical therapy, and surgery. As a rule, if treatment begins on time, the prognosis is favorable. However, therapy is quite long, it can take 2-3 years.