Glossopharyngeal Neuralgia Triggered by Non-Noxious Stimuli at Multiple Cephalic and Extracephalic Sites

Author:

Berg JWM ter1,Dupont P2,Schoenen J3

Affiliation:

1. Orbis Medical Centre, Dr. H. van der Hoffplein 1,6130 MB, Sittard-Geleen, The Netherlands

2. Centre for PET, Department of Nuclear Medicine, KU Leuven, Leuven

3. Department of Neurology, Headache Research Unit, University of Liège, Liège, Belgium [Correction added after online publication 9 April 2009: JWM ter Berg's affiliation address has been changed]

Abstract

Glossopharyngeal neuralgia (GN) triggered by non-noxious stimuli at multiple cephalic and extracephalic sites with positron emission tomography (PET) evidence for involvement of the upper brainstem has never been reported. We present such a patient, a 73-year-old man who since the age of 50 had suffered from GN with a high recurrence rate and very severe unilateral, non-familial GN episodes with very easy trigger zones widely extending beyond the n IX territory. Extensive neuroimaging and neurophysiological tests detected no precise underlying cause. PET scan revealed activation in the upper brainstem on extracephalic triggers. Single-fibre electromyography data will be discussed. We hypothesize that deficient inhibition as seen in trigeminal nociceptive reflexes on the level of brainstem interneurons, a functional lesion in the primary somatosensory cortex-sensory thalamic nuclei circuit and the dorsal column-thalamic pathway both activated by light touch may in part be involved in the extra- cephalic triggering.

Publisher

SAGE Publications

Subject

Neurology (clinical),General Medicine

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Glossopharyngeal Neuralgia: A Presentation of 14 Cases;Journal of Oral and Maxillofacial Surgery;2011-06

2. Tonsillolithiasis and orofacial pain;Gerodontology;2011-05-25

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