Osteochondrosis and glossopharyngeal nerve. Neuralgia of the glossopharyngeal nerve treatment with folk remedies

In modern neurology there is great amount diseases, and most of them are associated with inflammation or pinched nerves. In this article we'll talk about the cranial nerve, which is called the glossopharyngeal nerve, its anatomy, functions, types of damage and treatment methods. However, first things first...

The glossopharyngeal nerve (GN) is cranial and is considered the IX pair. From an anatomical point of view, it does not have the most complex structure, but it is not the simplest either. So, anatomy glossopharyngeal nerve:

The nerve contains motor, parasympathetic and sensory fibers. The YAN consists of three sections:

1. Tympanic nerve.
2. Lesser petrosal nerve.
3. Tympanic plexus.

In addition, like any cranial nerve, it has several branches, including:

• pharyngeal branches (innervation of the pharynx occurs together with the branches of the same name);
• carotid branch (innervates the carotid glomus);
• branch of the stylopharyngeal muscle (innervates this muscle);
• branches of the tonsils (innervate the tonsils, respectively, are located near them, are considered the shortest branches);
• lingual branches (located in the posterior third of the tongue and are responsible for the taste and general sensitivity of the tongue).

Carotid glomus is an anatomical formation located near carotid artery, which is intended to regulate blood pressure. Dysfunction of this education may lead to health problems.

The nuclei of the glossopharyngeal nerve are located at the back of the tongue and include:

1. Salivary nucleus (parasympathetic).
2. Nucleus of the solitary tract (responsible for taste).
3. Double nucleus (motor).

An interesting feature of the topography of the nerve nuclei is the fact that not only the nerve fibers originate in them, but also in other, no less important cranial nerves. For example, the accessory nerve (the accessory nerve innervates the muscles responsible for turning the head and the trapezius muscles) or the vagus (innervates a large number of internal organs).

Anatomy of a nerve

The nerve circuit is quite simple, but the same cannot be said about its functions.

The main function of the glossopharyngeal nerve is undoubtedly the determination of taste, however, it is not the only one, since it was previously indicated that the nerve contains both motor and parasympathetic fibers.

The motor function consists of innervation of the stylopharyngeal muscle, which raises and lowers the pharynx. As for the parasympathetic function, these fibers contribute to the production of the salivary glands.

Also, a simple function includes the sensitivity of some areas inside the mouth (tonsils, palate, tympanic cavity, Eustachian tube).

Causes of neuralgia

Like anyone else, this nerve predisposed to damage, and most of the reasons indicate the peripheral nature of the ailments (that is, not related to the central nervous system).

Main reasons

There are two subtypes of illnesses:

1. Primary ( hereditary predisposition, often an independent disease).
2. Secondary (occurs as a result of a concomitant disease, does not develop independently).

Neuropathy or neuralgia of the glossopharyngeal nerve can occur under the influence of the following factors and diseases:

• atherosclerosis;
• ENT diseases (otitis, tonsillitis, sinusitis);
• infectious diseases (flu, acute respiratory infections);
• compression of the nerve at any stage of its passage (a tumor or wound may contribute to this);
• general intoxication of the body;
• vascular aneurysms;
• oncology in the larynx;
• pinched or damaged tonsils;
• vegetative-vascular dystonia.

In some cases, when the cause of the disease cannot be determined, the doctor makes a diagnosis of idiopathic neuralgia of the glossopharyngeal nerve. Treatment in such a situation is no different from usual.

Clinical manifestations

Glossopharyngeal neuralgia (neuritis) appears more often in men over the age of 40 and has several characteristic symptoms, including:

• one-sided severe pain syndrome (paroxysm), which lasts up to three seconds (as a rule, the painful sensation begins to diverge from the root of the tongue, gradually moving to the tonsils, pharynx and ears);
• it is possible that the pain will radiate to the eyes, neck or lower jaw;
• dry mouth ( this symptom not permanent, but only at the time of the attack, and after the pain goes away it is observed heavy salivation. Depending on the human body this state may not appear, if other secretory glands are working well, then compression of the parotid glands will pass unnoticed);
• problems with chewing or swallowing saliva (in most cases it goes unnoticed);
• loss of sensitivity to the position of the tongue in the mouth;
• loss of consciousness;
• tinnitus;
• dizziness;
• “flies” before the eyes;
• weakness in the body.

Autonomic symptoms are also present, including:

1. Redness of the skin (on the neck and chin).
2. Feeling of presence foreign body in the throat ( rare manifestation), because of this sensation, the patient begins to be afraid to eat, as it seems to him that there is a foreign body in the throat. In this regard, mental disorders are possible.

A provoking factor for the development of internal pain syndrome can serve:

• sudden movement of the head or tongue;
• tongue irritation from excessively hot or cold drinks;
• coughing;
• chewing food;
• conducting a conversation;
• yawn.

One of the hallmark symptoms of YAN is a change in taste. For example, the patient often begins to feel bitterness in the mouth.

The clinical picture mistakenly indicates to the doctor that the patient has cholecystitis and he refers him for a gastroenterological examination, instead of a neurological one.

Another symptomatic mistake can occur directly with the neurologist. Thus, the pain that is characteristic of glossopharyngeal neuralgia can easily be confused with idiopathic, and it is possible to distinguish these two diseases only with the use of instrumental diagnostics.

Diagnostics

Since the nerve can become inflamed, both for unclear reasons and due to the presence secondary disease, diagnostic options may differ slightly.

So, if we're talking about about the primary type of illness, the doctor carries out an external examination of the patient, asks him about his condition, where and what hurts, the intensity and nature of the pain. Thus, the doctor collects anamnesis (signs of illness). It is important not to make a mistake in making a diagnosis, so as not to prescribe the wrong treatment to the patient.

At the second stage, the doctor proceeds to palpation (the parotid region, the area where the tonsils are located) is felt and pays attention to the patient’s reaction, to certain pressures, in order to thus differentiate the disease from another.

In the case when the disease is caused concomitant disease and there are signs of this disease, the doctor proceeds to instrumental methods diagnostics, which include:

• echoencephalography;
• electroencephalography;
• electroneuromyography;
• computed tomography;
• magnetic resonance imaging;
• consultation with other specialists (ENT doctor, dentist, ophthalmologist).

Ultrasound of the larynx

The nervous nature of the disease can arise as a result of inflammation of other nerves, or the formation of other diseases, so the disease has general symptoms with ailments such as:

• neuralgia of the ear canal;
• Oppenheim syndrome;
• occipital abscess;
• tumor of the ear canal.

Treatment

Glossopharyngeal neuralgia is treated in several ways, including:

1. Medication.
2. Surgical.

Additionally, it is possible to use recipes traditional medicine. However, home treatment methods should not be used instead of drugs prescribed by the doctor, but together with them in this case healing effect will be higher.

During the recovery period, it is possible to use physiotherapeutic procedures. It is also possible to use physiotherapy in conjunction with drug therapy.

Conservative treatment

Treating a patient with pills is not always bad, since conservative treatment has less harm for the body, despite the fact that it is longer. As a rule, a patient with glossopharyngeal neuralgia is prescribed:

• painkillers (most important drug during therapy, because sharp pain can drive you crazy. To eliminate pain, the patient is advised to take a 10% solution of cocaine, which is rubbed into the root, and if this does not help, 1–2% novocaine is injected under the root of the tongue. In addition, they may additionally prescribe non-narcotic painkillers that are taken orally);
• sedatives, hypnotics, antidepressants and antipsychotics (prescribed for severe pain);
• anticonvulsants (carbamazepine, phenytoin);
• immunostimulating drugs (to the body in mandatory support needed);
• vitamin complexes (traditionally, for nervous system B vitamins are needed, and a multivitamin complex, iron, etc. would also be useful).

As for physiotherapy, good effect provide the following procedures:

• diadynamic therapy (treatment pulse current 50–100 Hz);
• SMT therapy for the larynx and tonsils (modulated alternating current therapy);
• galvanization (exposure to direct current 50 mA);
• electrophoresis.

Surgical intervention

The main condition for carrying out surgical intervention- lack of effect from conservative treatment. Inflammation of the glossopharyngeal nerve can take quite a long time to be treated, but after some time it will become clear to the doctor whether there are positive results or not.

As for the treatment of neuralgia in a child, there are no special differences, with the exception of a reduced dosage of medications and the exclusion of some drugs from the course.

ethnoscience

As you know, the best remedy for treating any disease (in fact, not all) is home medicine. In the case of inflammation of the lingual nerve, this rule applies. Below are several recipes that can be used in parallel with the main treatment, after consulting with your doctor.

Willow bark decoction

10 g of bark is boiled for 20 minutes, then cooled and taken up to five times a day, one tablespoon

Rare ointment

As you know, radish horseradish is not sweeter, so any vegetable will do for rubbing into the affected area. It is necessary to grate any of the vegetables on a fine grater and simply rub it into the place where the problem is felt.

Valerian tincture

1 tbsp valerian root (can be replaced with rue) infused in boiled hot water at least 30 minutes. You need to take the tincture once a day, one glass.

Salt compress

Dissolve two tablespoons of salt in warm water and from the resulting solution you can make salt compresses to the site of pain.

Prevention

What can cause the disease? Concomitant diseases. Respectively, the best remedy prevention is to harden the body and prevent infection from entering the body.

In addition, our physiology really loves it when the body is comfortable, but it is worth remembering that not every comfort will be beneficial. For example, walks on fresh air wearing clothes out of season can lead to illness, which will subsequently result in neuralgia. And the recovery will be quite painful. Therefore, it is better to prevent than to prevent.

Healthy lifestyle, proper nutrition and refusal bad habits, no matter how trivial it may sound, best friends healthy person.

Moreover, the phenomenon of toothache and diseases associated with teeth are not the best companion for the glossopharyngeal nerve, treat your teeth on time. The infection can appear in the teeth, but be much deeper.

It is also better to ward off any diseases associated with the throat from a person, for the same reason as with teeth. Throat damage is even more dangerous, since it is located even closer to the lingual nerve.

So, glossopharyngeal neuralgia serious illness, which can develop in any person, regardless of sex or gender. If the first signs appear, do not delay your visit (although the nature of the pain is unlikely to allow you to do this). Take care of yourself and your nerves, don’t get sick!

Neuralgia of the glossopharyngeal nerve

The most common form of damage to the glossopharyngeal nerve is neuralgia of the glossopharyngeal nerve (Sicard syndrome, Weisenburg-Sicard-Robineau syndrome, Sicard-Robineau syndrome).

The disease occurs due to neuroinfection, intoxication, and also due to compression of the nerve by the hypertrophied styloid process of the temporal bone, ossified stylohyoid ligament, or a neoplasm in the area of ​​the root of the tongue and larynx. The cause of the disease can also be compression of the nerve root by dilated or elongated vessels, usually the posterior inferior cerebellar and vertebral arteries.

The disease is characterized by paroxysmal pain, often starting from the root of the tongue or tonsil and spreading to curtain of palate, throat, ear. Sometimes the pain starts in the ear and spreads to the tonsil. IN in some cases There is irradiation of pain in the area of ​​the eye, cheek, and angle of the lower jaw. Patients characterize the pain as burning, shooting, reminiscent of an electric shock.

The duration of painful attacks ranges from several seconds to three minutes, the interval between them is not the same. The intensity of pain also varies: from moderate to unbearable. In most cases, patients note increased pain when eating sour, bitter and salty foods. During a painful attack, salivation increases, and some patients experience a severe laryngeal cough. Hearing disturbances are possible.

In most patients, attacks appear in the morning, more often they develop suddenly against the background of complete somatic well-being, and much less often - after the appearance of precursors of the disease in the form of various local paresthesias. An attack of pain can be provoked by talking, laughing, yawning, eating, moving the head, or changing the position of the body. When an attack occurs, patients press or intensively rub with their hand the lower part of the parotid-masticatory or retromaxillary area on the painful side.

Upon external examination, a characteristic “antalgic” posture of the patient is observed with the head tilted towards the side of pain, as well as hyperemia of the facial skin on the affected side. Most often, neuralgia of the glossopharyngeal nerve has a left-sided localization.

When examining the oral cavity, swelling and hyperemia of the mucous membrane of the tongue is noted. In some cases, the presence of plaque is determined on the root of the tongue.

Diagnostic neurological tests indicate the absence of a pharyngeal reflex, as well as the presence of areas of hyper- and hypoesthesia, most often detected in the area of ​​the root of the tongue, less often in the posterior parts of the soft palate. The trigger zones are most often localized in the area of ​​the tonsils, the root of the tongue, and less often in the tragus of the ear.

Neuralgia of the glossopharyngeal nerve is differentiated from trigeminal neuralgia, painful dysfunction of the temporomandibular joint, and tympanic plexus syndrome.

Treatment. Patients with neuralgia of the glossopharyngeal nerve are treated in a specialized hospital.

Complex treatment includes the prescription of anticonvulsants, tranquilizers, antidepressants, neuroleptics, non-steroidal anti-inflammatory drugs, non-narcotic analgesics, vasodilators, biostimulants, vitamins B1, B6, B12 and PP.

To relieve attacks of pain, physical treatment methods are used - hyperbaric oxygenation, transcutaneous electrical stimulation, acupuncture, darsonvalization, hydrocortisone phonophoresis, diadynamic therapy, fluctuarization, amplipulse therapy, massage.

In some cases, surgery is indicated - resection of the styloid process, microsurgical decompression of the glossopharyngeal nerve root.

Providing emergency care to a patient with glossopharyngeal neuralgia on an outpatient basis. To relieve pain, local anesthetics are applied to the mucous membrane of the root of the tongue and pharynx. In some cases, it is possible to administer a solution local anesthetic according to the type of infiltration anesthesia in the area of ​​the root of the tongue. The patient is prescribed non-narcotic analgesics.

The glossopharyngeal nerve becomes inflamed relatively rarely. His clinical picture quite bright. Trigeminal neuralgia can be caused by many reasons. She is being treated by a neurologist. This article will discuss the main causes of inflammation of the glossopharyngeal nerve, its symptoms, and the basic principles of diagnosis and treatment.

General characteristics of the disease and the mechanism of development of the inflammatory process

Neuralgia of the glossopharyngeal nerve, according to the WHO, is more common in men. Depending on the cause and mechanisms of occurrence, inflammation of the glossopharyngeal nerve is usually divided into two forms:

1. Idiopathic, or primary. In this form, the cause of the development of neuritis of the glossopharyngeal nerve is not known. It develops without any previous disease.
2. Secondary. In this form, neuritis of the glossopharyngeal nerve is only a symptom of some kind of existing disease. Most often, it develops against the background of such diseases:

• acute respiratory viral infection, ARVI;
• flu;
• stenotic laryngotracheitis;
• tonsillitis;
• atherosclerotic process in blood vessels;
• chronic tonsillitis;
• carotid artery aneurysm;
• benign or malignant tumor cerebellopontine angle;
• malignant tumor, laryngeal cancer;
• injury or burn to the tonsils;
• acute or chronic poisoning tetraethyl lead.

Clinical picture of the disease

Neuralgia of the glossopharyngeal nerve manifests itself very specific symptoms, which are very difficult to confuse with other pathologies. Nerve inflammation in itself is not dangerous. But it brings a lot of suffering to the patient. The main symptoms of neuritis of the glossopharyngeal nerve are presented in the table below:

As a rule, neuralgia of the glossopharyngeal nerve is a chronic disease. It proceeds cyclically, exacerbation is replaced by remission. At first, pain occurs only during an exacerbation, but as it progresses, it may be present to a lesser extent almost all the time, intensifying with food intake.

Basics of diagnosis and making an accurate diagnosis

For appointment proper treatment, it is necessary to determine the cause of attacks of neuralgia of the glossopharyngeal nerve. It is also necessary to exclude diseases such as aneurysm and malignant tumors. For a complete differential diagnosis, a neurologist needs data from the following research methods:

Principles of treatment of neuritis of the glossopharyngeal nerve

Idiopathic form neuritis is treated only symptomatically, and in the treatment of the secondary form, main role etiological therapy aimed at eliminating the primary disease plays a role.

Symptomatic treatment common to two forms of neuralgia. It consists of the following components.

Anti-inflammatory drugs

They are blockers of cyclooxygenase, which is involved in creating the inflammatory response. These drugs should not be taken by people with gastroduodenitis and peptic ulcer. You can take them strictly after good reception food. The most commonly used representatives of non-steroidal anti-inflammatory drugs are:

• Diclofenac;
• Indomethacin;
• Ibuprofen;
• Aspirin;
• Analgin;
• Piroxicam;
• Meloxicam;
• Nimesulide.

Edema is one of the main components of any inflammation. Neuralgia of the glossopharyngeal nerve is no exception. The nerve fiber, when inflamed, attracts many inflammatory mediators, which, in turn, retain excess liquid. This fluid, squeezing the nerve fiber, significantly increases the manifestations of pain. For neuralgia, the following drugs can be used in small dosages:

• Furosemide;
• Torasemide;
• Lasix;
• Spironolactone;
• Bumetanide.

Antihistamines

These medications directly affect the most important mediator of inflammation - histamine. By blocking it, they also relieve the inflammatory process. For neuritis, you can use the following antihistamines:

• Cetrin;
• Loratadine;
• Diazolin;
• Claritin;
• Suprastin;
• Astemizole;
• Cetirizine;
• Levocetirizine;
• Desloratadine.

Treatment of dehydration

For any inflammatory process There is a pronounced loss of fluid from the body. If it is very painful for the patient to drink on his own, then it is better to administer his saline and colloidal solutions intravenously.

You should not self-medicate. Symptomatic treatment can begin to be used only after exclusion of primary dangerous diseases. All dosages and frequency of administration must be discussed with the treating doctor.

Neuritis of the glossopharyngeal nerve is a rare chronic disease that often occurs in men. There are two main forms of neuritis - idiopathic and symptomatic. For symptomatic neuritis, therapy should be aimed at primary disease, which became the cause of the pain syndrome. Idiopathic neuralgia is treated only symptomatically by a neurologist. Treatment consists of non-steroidal anti-inflammatory drugs, diuretics and antihistamines. Also, in the treatment of neuritis, an important component of therapy is restoration water-salt balance.

The glossopharyngeal nerve (n. glossopharyngeus) is part of the IX pair of cranial nerves. Comprises different types fibers: parasympathetic, motor and sensory.

Anatomy of the glossopharyngeal nerve

The nerve leaves the medulla oblongata usually with 4-6 roots behind the inferior olive near the tenth and eleventh nerves. Collecting into one single nerve, they leave the skull through the jugular foramen, at this point the tympanic nerve separates from the main trunk.

In the foramen, the glossopharyngeal nerve thickens slightly, forms the superior node, and immediately after exiting the inferior node. The first sensitive neurons are located in them and impulses from them are sent to the nucleus responsible for sensitivity.

Next, the nerve descends to the internal carotid artery, passes between it and the internal jugular vein, makes a bend in the shape of an arc, after which it gives one of its branches to the place of division of the carotid artery, namely to the carotid sinus. After separating the sinus branch, it moves to the pharynx, where it begins to branch and gives off several branches:

• Pharyngeal two or three small branches
• tonsils - conduct impulses from the soft palate, tonsils
• Linguistic - three or four, they provide taste sensations, general sensitivity from the posterior third of the tongue

The motor part of the nerve innervates the stylopharyngeal muscle.

Parasympathetic fibers: the lesser petrosal nerve reaches the auricular ganglion, then the postganglionic fibers pass into the parotid salivary gland, which is innervated.

In the screenshot below we see 3 pairs of nuclei of the glossopharyngeal nerve. They are all marked with different colors.

Inferior salivary nucleus (highlighted yellow) - parasympathetic.

The nucleus of the solitary tract is marked in green. It is responsible for the sensation of taste in the back third of the tongue. From the nucleus, information about taste enters the thalamus. Scientists learned that this nucleus is responsible for taste sensitivity at the end of the 19th century.

For simplicity, we can say that the fibers of the ninth nerve connect to middle part kernels. Whereas the fibers of the seventh nerve occupy the upper third, and the tenth - the lower.

The double nucleus, marked in pink, is the motor nucleus. The fibers of the tenth and eleventh nerves also originate from it. Central motor neurons located in lower sections precentral gyrus.

Interesting fact: there is evidence that the fourth nucleus is determined - the spinal nucleus of the trigeminal nerve - and it is responsible for general sensitivity from areas such as the soft palate, throat, auditory tube and the tympanic cavity. Usually it is not indicated, since it is very a small amount of axons.

Functions of the glossopharyngeal nerve

Although it is mixed, it is one of the most important functions will provide recognition of taste, to be more precise - salty and bitter, from the back third of the tongue. This is one of the first signs, which is very helpful if a violation of the ninth nerve is suspected.

The second serious task is the transmission of impulses general sensitivity from areas where sensitive branches approach.

Vegetative fibers ensure adequate functioning secretory function parotid salivary gland.

A small portion of motor fibers provides innervation to the stylopharyngeal muscle, which raises the pharynx during swallowing.

Lesions of the glossopharyngeal nerve

Symptoms

One of the first symptoms is a loss of general sensitivity in the innervated zones; a change in the understanding of the position of the tongue in the oral cavity is possible, which interferes with the normal grasping and chewing of food. The definition also suffers taste qualities food, namely salty and bitter (these zones for determining taste are located in the area just in the last third of the tongue). It appears only if there is a violation in the nerve itself or the nucleus responsible for the perception of taste is damaged.

It should be said that a decrease in taste perception is also possible due to diseases of the tonsils, the presence of a dense coating on the tongue, so you need to pay attention to the condition of the tongue and oral cavity, when we carry out the determination of taste. It is also necessary to know about chronic diseases a person and the medications he takes (especially antibiotics), because this can also affect the sense of taste.

In the presence of a pathological process that irritates the IX cranial nerve, sometimes there is constant or paroxysmal pain in the throat, back of the tongue, back wall pharynx, eustachian tube, middle ear.

Interesting fact: there is a separate syndrome of neuralgia of the glossopharyngeal nerve or Sicaro-Rabino syndrome. It is characterized by acute paroxysmal pain from the tonsil or at the root of the tongue, which radiates to the ear, neck or lower jaw. These attacks can occur when swallowing or eating cold or hot food.

May not occur severe dryness in the oral cavity, but this is not reliable and not constant sign, because the weak function of one salivary gland can be replaced by the work of others.

Another sign of glossopharyngeal nerve damage is weakness when testing the palatal and pharyngeal reflexes on the affected side. You should definitely remember that the IX and X pairs are connected very closely, which means that when checking the above reflexes, detecting their weakness, you need to think not only about the glossopharyngeal nerve, but also remember about the vagus.

Test: drop one by one different types solutions: sweet, salty, sour and bitter - onto symmetrical areas of the surface of the tongue separately in each third of it. Substances are applied using a pipette or moistened filter paper. The liquid should not be allowed to spread over the mucous membrane. After each solution, rinse your mouth thoroughly to ensure accurate results samples.

Treatment of the glossopharyngeal nerve

To treat a dysfunction of this nerve, it is necessary to find out the root cause that causes the appearance of certain symptoms. Perhaps this is kinking and compression of the nerve root of a crowded inferior cerebellar or vertebral artery, the presence of inflammatory, tumor formations, as well as aneurysms in the area of ​​the skull where the glossopharyngeal nerve comes to the surface.

Neuralgia of the glossopharyngeal nerve is a lesion of the IX pair of cranial nerves, which manifests itself in the form of paroxysmal pain on one side of the root of the tongue, in the middle ear, palate, pharynx and tonsils.

In the posterior third of the tongue, taste perception is impaired, salivation is impaired, and the palatal and pharyngeal reflexes are reduced.

Glossopharyngeal neuralgia is quite rare pathology, and often develops after 30-40 years.

They call pain in the place where it occurs nerve ending. The difference between neuralgia and neuritis is the absence of an inflammatory reaction.

Anatomy and function of the nerve

The glossopharyngeal nerve is the IX pair of cranial nerves. It is mixed - its structure includes autonomic parasympathetic, sensory and motor fibers.

The nerve comes out medulla oblongata, and exits through the jugular foramen along with the internal jugular vein, accessory, . Fibers in a nerve exit from different nuclei.

Sensitive nerve fibers originate in the sensitive nucleus of the glossopharyngeal and vagus nerves, and provide communication with the mucous membrane of the tonsils, pharynx, soft palate, eustachian tube, tympanic cavity, tongue.

Top view of the glossopharyngeal and all other cranial nerves

Taste fibers emerge from the medulla oblongata (nucleus of the solitary tract) and provide taste perception to the posterior third of the tongue.

Motor nerve fibers emerge from the nucleus ambiguus and provide innervation only to the stylopharyngeal muscle, which is responsible for raising the larynx and pharynx. Motor, sensory fibers and nervus vagus are components reflex arc palatal and pharyngeal reflexes.

Autonomic parasympathetic fibers originate in the inferior salivary nucleus as part of the tympanic nerve, then pass into the lesser petrosal nerve and reach the auricular ganglion, where they become trigeminal nerve, reach parotid gland, in which they regulate secretory function.

The glossopharyngeal nerve itself is rarely affected, and symptoms often extend to the accessory and vagus nerves.

What provokes the development of neuralgia?

Neuralgia of the glossopharyngeal nerve can occur as a separate independent disease, and in this case it is not possible to establish the causes of its occurrence. Also, neuralgia can also occur as a symptom or as a complication of another disease.

Idiopathic (primary, without a specific cause) neuralgia of the glossopharyngeal nerve can be caused by various factors:

• infectious diseases of the ear, nose and throat;
• viral infections;
• various intoxications;
• tonsil injuries.

The secondary nature of the disease can be caused by:

Some experts consider neuralgia of the glossopharyngeal nerve as the first sign oncological diseases in the throat and pharynx area.

How it appears and feels

The disease begins to manifest itself with unilateral pain that lasts no more than a few minutes. The pain syndrome increases and occurs in the form of attacks that occur only on one side.

Painful sensations occur at the root of the tongue, the area of ​​the tonsils, and spread to the area of ​​the soft palate, pharynx, and ear. The sensation may spread to the neck, eye, and lower jaw.

During attacks, dry mouth is also observed, and after an attack, salivation becomes profuse. Painful attacks can be triggered by speech, eating food with an excessively high or low temperature, chewing food, yawning, coughing, and swallowing.

Weakening of the stylopharyngeal muscle with neuralgia of the glossopharyngeal nerve causes a lump in the throat, however, it is little pronounced due to the insignificant role of this muscle in the swallowing process. Sensory disorders may cause problems with swallowing and chewing food.

Neuralgia of the glossopharyngeal nerve has periods of remission and periods of exacerbation in its development, usually periods of exacerbation occur in the cold season (autumn and winter), and in the absence of pain, symptoms such as a burning sensation and twitching near the root of the tongue appear, which intensify with coughing and eating. Cough occurs frequently and is caused by the sensation of a foreign body in the throat.

Except clinical signs diseases, there are also such general symptoms, as reduced arterial pressure, arrhythmia and other changes in heart rate, weakness in the limbs, loss of consciousness.

The important point is the correct diagnosis

Diagnosis of glossopharyngeal neuralgia is carried out by a neurologist. Additionally, consultations with a dentist and otolaryngologist are prescribed to exclude clinically similar diseases of the throat, ear and oral cavity.

During the examination, the neurologist checks for pain at the base of the tongue, tonsils, upper sections throats, soft palate; examines taste sensitivity by applying a special solution to symmetrically located areas of the tongue.

It is important to determine the sensitivity disorder on one side of the posterior third of the tongue, since it is the unilateral taste disorder that is the main symptom of the disease.

The neurologist also checks the palatal reflex (touch is followed by raising the palate and its uvula), pharyngeal reflex (swallowing, coughing, gagging movements as a reaction to touch). The absence of these reflexes on one side indicates that the lingual nerve is damaged.

It is necessary to carry out differential diagnosis with the following diseases:

• nodes of the glossopharyngeal nerve (the presence of herpetic vesicles indicates the presence of the disease);
• (presence of areas of elevated pain sensitivity in the lip area);
• neuralgia of the ear ganglion;
• pharynx tumors.

To detect the causes of secondary neuralgia, the following is used:

• echoencephalography;
• ophthalmoscopy;

Health care

For neuralgia of the glossopharyngeal nerve it is used conservative methods treatment and surgery.

In most cases surgical methods are not required, with the exception of compression of the nerve, for example, with a hypertrophied styloid process.

Treatment is aimed at reducing the intensity and completely relieving pain. To do this, lubricate the root of the tongue with a solution of dicaine or other anesthetics. This allows you to remove painful sensations for 6 hours. Recommended for more persistent pain Novocaine injections into the root of the tongue.

In addition to injections, an appointment is prescribed non-narcotic analgesics(Naproxen, Ibuprofen, Butadion, Analgin), anticonvulsants(, Butadiona).

To further alleviate the condition of patients, it is recommended to take sedatives, sleeping pills, B vitamins, and antidepressants.

It is considered effective, namely (SMT therapy) and, with an effect on the tonsils, the area behind the jaw and the oropharynx. Galvanization is also used (the anode is placed at the root of the tongue, the cathode is placed at the back of the jaw).

The surgical treatment method involves releasing the nerve from compression by surrounding tissues. The risks of complications are reduced thanks to the use of microscopic endoscopic equipment.

The patient underwent surgery - microvascular decompression of the glossopharyngeal nerve:

Neuralgia of the glossopharyngeal nerve leads to a decrease in the patient’s quality of life and interferes with active work, significantly limits normal food intake, expression of emotions, and affects sleep. Prolonged course of the disease can lead to loss of weight and appetite.

Possible development depressive states, apathy. The prognosis with timely treatment is favorable. Treatment may take long time, up to several years.