X-rays of the arteries with a dye (conventional angiography)
The goal of treatment is to control pain. Over-the-counter painkillers such as aspirin and acetaminophen (Tylenol) are not very effective for relieving glossopharyngeal neuralgia.
The most effective drugs are antiseizure medications, such as carbamazepine, gabapentin, pregabalin, and phenytoin. Some antidepressants, such as amitriptyline or nortriptyline, may help certain people.
In severe cases, when pain is difficult to treat, surgery to take pressure off the glossopharyngeal nerve may be needed. This is called microvascular decompression. Or, the nerve can be cut (rhizotomy). Both surgeries are generally considered effective. If a cause of the neuralgia is found, treatment should control the underlying problem.
How well you do depends on the cause of the problem and the effectiveness of the first treatment. Surgery is considered effective for people who do not benefit from medications.
Slow pulse and fainting may occur when pain is severe.
Medications used to treat this condition can have side effects.
Calling your health care provider
Call your health care provider if you have symptoms of glossopharyngeal neuralgia. See a pain specialist if the pain is severe to be sure that you are aware of all your options for controlling pain.
Cutrer FM, Moskowitz MA. Headaches and other head pain. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 421.
Ferroli P, Fioravanti A, Schiariti M, Tringali G, Franzini A, Calbucci F, Broggi G. Microvascular decompression for glossopharyngeal neuralgia: a long-term retrospective review of the Milan-Blogna experience in 31 consecutive cases. Acta Neuochir (Wien). 2009;151:1245-1250.
C. Gaul , P. Hastreiter, A. Duncker, and R. Naraghi. Diagnosis and neurosurgical treatment of glossopharyngeal neuralgia: clinical findings and 3-D visualization of neurovascular compression in 19 consecutive patients. J Headache Pain. 2011; 12:527–534.
Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.