Abstract
ULTRASOUND-GUIDED GLOSSOPHARYNGEAL NERVE BLOCK FOR GLOSSOPHARYNGEAL NEURALGIA: A CASE REPORT
1Edgars Vasiļevskis, 2Gundega Ose*, 1Natalija Zlobina, 1Irina Evansa. 1Anesthesiologist, Riga 1st Hospital, Riga, Latvia; 2Riga Stradins University, Riga, Latvia 10.1136/rapm-2024-ESRA.278
Background and Aims Glossopharyngeal neuralgia is a rare cranialneuralgia that presents as recurring episodes of shooting sharp pain in the jaw, throat, tongue, and ear. This case report demonstrates a rare treatment of glossopharyngeal neuralgia with peripheral nerve block under ultrasound guidance.
Methods A 69-year-old woman presented with unilateral, transient, piercing pain in the ear, the base of the tongue, tonsillar fossa, posterior pharynx, and submandibular region. It was triggered by chewing, swallowing, talking, yawning, or coughing. During the physical examination, the posterior wall of the ear canal was found to be painful when touched with a Q-tip. Head and neck MRI was unremarkable. She had previously failed to respond to pharmacological treatment. A diagnosis of glossopharyngeal neuralgia was considered. She underwent an ultrasound-guided anesthetic block of the glossopharyngeal nerve, 0.5% lidocaine and 40 mg methylprednisolone were slowly injected under real-time ultrasound
guidance.
Results The patient had analgesic effects within 5 minutes ofthe injection. Following the treatment, the patient experiencedjust three moderate and short-lived episodes of pain over 24 hours. Subsequently, the patient returned to their baseline without any discomfort. She has not had another flair for three months since the block.
Conclusions Currently, primary glossopharyngeal neuralgia is challenging to treat. Treatment includes carbamazepine, gabapentin, baclofen, or neurosurgical procedures if medication fails. We report the ultrasound-guided glossopharyngeal nerve block as a successful treatment for glossopharyngeal neuralgia
1Edgars Vasiļevskis, 2Gundega Ose*, 1Natalija Zlobina, 1Irina Evansa. 1Anesthesiologist, Riga 1st Hospital, Riga, Latvia; 2Riga Stradins University, Riga, Latvia 10.1136/rapm-2024-ESRA.278
Background and Aims Glossopharyngeal neuralgia is a rare cranialneuralgia that presents as recurring episodes of shooting sharp pain in the jaw, throat, tongue, and ear. This case report demonstrates a rare treatment of glossopharyngeal neuralgia with peripheral nerve block under ultrasound guidance.
Methods A 69-year-old woman presented with unilateral, transient, piercing pain in the ear, the base of the tongue, tonsillar fossa, posterior pharynx, and submandibular region. It was triggered by chewing, swallowing, talking, yawning, or coughing. During the physical examination, the posterior wall of the ear canal was found to be painful when touched with a Q-tip. Head and neck MRI was unremarkable. She had previously failed to respond to pharmacological treatment. A diagnosis of glossopharyngeal neuralgia was considered. She underwent an ultrasound-guided anesthetic block of the glossopharyngeal nerve, 0.5% lidocaine and 40 mg methylprednisolone were slowly injected under real-time ultrasound
guidance.
Results The patient had analgesic effects within 5 minutes ofthe injection. Following the treatment, the patient experiencedjust three moderate and short-lived episodes of pain over 24 hours. Subsequently, the patient returned to their baseline without any discomfort. She has not had another flair for three months since the block.
Conclusions Currently, primary glossopharyngeal neuralgia is challenging to treat. Treatment includes carbamazepine, gabapentin, baclofen, or neurosurgical procedures if medication fails. We report the ultrasound-guided glossopharyngeal nerve block as a successful treatment for glossopharyngeal neuralgia
Original language | English |
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Pages (from-to) | A198-A198 |
Journal | Regional Anesthesia and Pain Medicine |
Volume | 49 |
Issue number | S1 |
DOIs | |
Publication status | Published - 28 Sept 2024 |
Event | The European Society of Regional Anaesthesia and Pain Therapy - Prague, Czech Republic Duration: 4 Sept 2024 → 7 Sept 2024 Conference number: 41 https://2024.esracongress.com |
Field of Science*
- 3.2 Clinical medicine
- 3.1 Basic medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)