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GLOSSOPHRARNGAYNGIAL NEURALGIA - Coggle Diagram
GLOSSOPHRARNGAYNGIAL NEURALGIA
DIFFERENTIAL DIAGNOSIS :
- 1. Trigeminal neuralgia
Supraorbital neuralgia
Superior laryngeal neuralgia
Jacobson neuralgia
Eagles syndrome
DEFINITION:
- GN produces an electric, shooting pain in the sensory distribution of the auricular and pharyngeal branches of the IX and X cranial nerve
CLASSIFICATION
BASED ON CAUSE
Secondary
Idiopathic
BASED ON IHS
Symptomatic (persistent pain)
Classical (occasional and episodic pain)
BASED ON PAIN DISTURIBUTION
Otitic Pain (Ear Lobe)
Oropharyngeal pain (near neck and maxillary fossa)
TRIGGER
:- Talking, Swallowing, Yawning, Coughing, Lateral jaw movement & Abrupt head movement
SIDE
:- Left side of face (M > F)
FREQUENCY
:- 200 times/day
DURATION
:- 2 sec.- 2 min.
SITE
:- Ear, Base of tongue, Throat, Tonsillar fossa & Angle of jaw
INVESTIGATIONS
:- MRI, CT scan CONFIRMATORY TEST:- Distinctive U/L, severe piercing episodic pain in throat triggered on swallowing.
PATHOPHYSIOLOGY
Idiopathic: GPN compression of posterior inferior cerebellar artery (PICA)
Secondary
1) Tumor :Cerebello pontine angle
2)infection : Tonsilitis, Pharyngitis, Arachnoiditis
TREATMENT
Medical
: carbamazepine (1st drug of choice ), Gabapentin +Baclofen, Pregabalin
Surgical
: GN Block, Microvascular decompression, Risotomy of GP nerve
Non- Pharmacological ( Physiotherapy )
: Ultrasound guided rPMS - case report (2022) Dosage : 50Hz triplet pulses at 5Hz with cycle time of 10s for 120s cycles and total of 3600 pulses