Glossopharyngeal Neuralgia With Cardiac Syncope

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Abstract
Glossopharyngeal neuralgia is an uncommon cause of severe unilateral oropharyngeal, cervical, and aural pain. It resembles the more familiar trigeminal neuralgia in its paroxysmal nature and severity of attacks, but differs in location and distribution of pain. In addition, the trigger zones are infrequent as compared with trigeminal tic.1 Although usually an isolated phenomenon, it is accompanied occasionally by other features such as hypersecretion from the ipsilateral parotid gland and cerebral and cardiovascular disturbances.1 We describe the clinical course of an elderly patient whose glossopharyngeal neuralgic attacks were complicated by severe bradycardia and syncope. The syncopal episodes were prevented by insertion of a demand transvenous pacemaker, while paroxysms of pain were finally controlled with carbamazepine therapy. PATIENT SUMMARY A 72-year-old woman was admitted to Bridgeport Hospital in July 1974, with a two-week history of occasional episodes of very severe sharp pain in the right side of the throat