[Clinical response of gabapentin for glossopharyngeal neuralgia]

The analgesic effect of the antiepileptic drug gabapentin makes it useful as an alternative for neuropathic pain. Its structural resemblance to other GABAergic antiepileptic drugs does not explain its mechanism of action, which seems not to depend on the activation of GABA receptor. Glossopharyngeal neuralgia is a rare entity which presents paroxystic crisis of pain, often with unknown etiology and poor response to treatment.

Nine patients bearing of IX root neuralgia resistant to other therapies and ages ranged from 43 to 71 years old are being treated with gabapentin at doses between 800 and 3,600 mg daily in a period of time between two and sixteen months. Four cases in which magnetic resonance detected a compression of the nerve by posterior inferior cerebellar artery were submitted to a decompression surgery, but it was not effective. Gabapentin, alone or in association to carbamazepine, reduced the frequency and severity of crisis in seven patients, but in those with vascular compression the response was poorer.

Gabapentin can be considered as an useful option for the management of glossopharyngeal neuralgic crisis, associated or not to other agents, for a short and long time, because of its good tolerance and lack of interactions.