Glossopharyngeal neuralgia as initial symptom in combined hyperactive dysfunction syndrome: case report

Area of Science:

• Neurosurgery
• Neurology
• Cranial Nerve Disorders

Background:

• Hyperactive dysfunction syndrome (HDS) encompasses cranial nerve overactivity, including trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN).
• Combined hyperactive dysfunction syndrome (CHDS) is characterized by a combination of these neuralgias, potentially affecting one or both sides, synchronously or metachronously.

Observation:

• A 73-year-old male presented with CHDS, with glossopharyngeal neuralgia (GPN) as the initial symptom.
• This patient experienced complete symptom relief from GPN, TN, and HFS following microvascular decompression surgery.

Findings:

• The reported case is the first documented instance of CHDS where glossopharyngeal neuralgia (GPN) was the presenting symptom.
• The unique aspect of this case involves offending vessels of both arterial and venous origin.

Implications:

• Microvascular decompression is an effective treatment for combined hyperactive dysfunction syndrome (CHDS).
• This case expands the understanding of CHDS presentation and etiology, highlighting the importance of considering combined cranial nerve involvement.
• Further research into CHDS, particularly cases with mixed vascular origins, is warranted to refine diagnostic and treatment strategies.