Tuesday, November 21, 2006

Barb H's Brother-in-Law needs our prayers

Hi Marston:
This is an operation our brotherinlaw is having on Wednesday its about
a 5 hour operation which they have to open the back of his brain, very risky. Will let you know how he makes out on Wednesday
Take care

Glossopharyngeal neuralgia


Glossopharyngeal neuralgia is a condition marked by repeated episodes
of severe pain in the tongue, throat, ear, and tonsils, which can last
from a few seconds to a few minutes.

Causes, incidence, and risk factors

Glossopharyngeal neuralgia is believed to be caused by irritation of
the ninth cranial nerve. Symptoms usually begin in people over 40 years of

In most cases, the source of irritation is never discovered.
Nevertheless, tumors or infections of the throat and mouth, compression of the
glossopharyngeal nerve by neighboring blood vessels, and other lesions
at the base of the skull can sometimes cause this type of neuralgia
(nerve pain).

Symptoms include severe pain in the areas connected to the ninth
cranial nerves. This includes the throat, tonsillar region, posterior third of
the tongue, nasopharynx (back of nose and throat), larynx, and ear. The
pain is episodic and may be severe. It can sometimes be triggered by
swallowing, chewing, speaking, laughing, or coughing.

Signs and tests

Tests will be done to identify an abnormality at the base of the
skull, particularly tumors. These may include x-rays, CAT scan of the head,
and head MRI. Sometimes the MRI may show evidence of inflammation of the
glossopharyngeal nerve.

To determine whether a blood vessel is compressing the nerve, pictures
of the brain arteries may be obtained using magnetic resonance
angiography (MRA) or conventional angiography (x-rays of the arteries with a dye).

Occasionally, certain blood tests may be needed when the diagnosis is
not clear, to rule out other causes of peripheral nerve problems
(neuropathy), such as high blood sugar.

Treatment is aimed at controlling pain. Unfortunately,
over-the-counter pain killers such as aspirin and acetaminophen are not very effective for the relief of neuralgia. The most effective drugs are actually
anti-seizure medications, like carbamazepine, gabapentin, and phenytoin. Some
anti-depressants like amitriptyline are sometimes tried with variable
degrees of success.

In severe cases, when pain is difficult to treat, surgery aiming at
decompressing the glossopharyngeal nerve may be required. This surgery
is generally considered effective. If a cause of the neuralgia is
identified, the treatment of choice is the control of the underlying problem.

Expectations (prognosis)

Prognosis depends on the underlying cause and the effectiveness of
initial treatment. Surgery is considered effective for cases that do not
benefit from medications.

Complications Return to top

Decreased pulse and fainting may occur when pain is severe.
Side-effects of medications may complicate treatment.

Thanks Barb Hamilton.
We all wish him well and hope it goes successfully

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