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[Glossopharyngeal neuralgia with syncope]
E Thombansen1, M M Menges, W Thimme
1I. Innere Abteilung des Humboldt-Krankenhauses, Berlin.
Deutsche Medizinische Wochenschrift (1946)
|June 12, 1992
Summary
A patient experienced syncope due to glossopharyngeal neuralgia with cardiovascular involvement, showing heart block and asystole. Surgical division of the glossopharyngeal nerve provided partial symptom relief.
Area of Science:
- Cardiology
- Neurology
- Otolaryngology
Background:
- A 26-year-old male, treated for tonsillar carcinoma 11 years prior, presented with recurrent syncopal episodes.
- Symptoms included burning ear pain radiating to the throat and tonsil, preceding each syncopal event.
Observation:
- Electrocardiogram (ECG) revealed complete atrioventricular (AV) block with a slow idioventricular rhythm and a 13-second asystole.
- 24-hour blood pressure monitoring showed hypotension (65/50 mm Hg) coinciding with pain and dizziness.
Findings:
- The patient was diagnosed with glossopharyngeal neuralgia exhibiting cardiovascular manifestations.
- Initial treatment with carbamazepine was ineffective.
- Surgical division of the glossopharyngeal nerve resulted in partial symptom improvement, but the patient declined further vagal nerve intervention.
Implications:
- This case highlights a rare association between glossopharyngeal neuralgia and severe cardiac events like AV block and asystole.
- It underscores the importance of considering neurological causes for unexplained syncope, even years after cancer treatment.
- Glossopharyngeal nerve sectioning may be a therapeutic option for refractory cases, though complete resolution is not guaranteed.