Medicine & surgery for Glossopharyngeal Neuralgia

[Shyambgupta]

My brother aged 49 is suffering from Glossopharyngeal Neuralgia since last 4 years. Medicines prescribed by doctors worked for about 3.5 years. Now the dose of Tegretol is increased with slight change in medicines.
The present prescription is as follows.
Tab Tegretol 300,200,300 mg
Tab TRD contin 1 BD
Tab Gabantin forte 300 mg TDS
Tab Tryptomer 10,10, 25 mg
Tab Rablet 1 BBF
Tab Epsoline 100, 100, 300 mg
In my opinion, the combination may increase or decrease the effect of one or the other drug?
Kindly advise on prescription.
He has also gone under Glossopharyngeal nerve block with extra & intra approach. His present condition is just to be at home with liquid diet and planning for surgery. Whether surgery is the only remedy now? Can the condition reoccur after surgery?

Thanks in advance.
Soft

[Sugar205]

I urge anyone suffering to check into Eagle Syndrome. I  had glossopharyngeal neuralgia and microvasc. decomp. surgery to correct it but it was a long path to finding a diagnosis and trying medications. My ENT evaluated me for Eagle syndrome but while it wasn't my ultimate diagnosis, ironically,a close friend was diagnosed with it a year later. He underwent surgery and is fine now.

[Er1003]

I have had 3 MVDs for glossopharyngeal neuralgia. Im getting about 5 years of relief before it returns. The problem that im having is that i have veins that are compressing the nerves and when they  burn them off they grow back over time. You are far better off if its a artery compressing the nerve.

[elantra2006]

Hi,

I am familiar with this ailment as I have suffered with it for two years. I started with a sore throat that went away for a brief period then came back. Went to my PCP with the complaint and therefore tried anti-biotics, allergy medication & testing for thyroid. Everything came back normal so I said enough! Send me to an ENT doctor. Upon my first visit, he diagnosed me with nuralgia. I then looked to the Internet for help and low and behold there really was an actual disorder. I had all the symptoms stated. I was put on gabapentin and it worked for nearly a year (did have pain on and off throughout). Then the pain came back and the ENT said there was nothing else he could do for me and sent me to a nerurosurgeon. They wanted to do surgeyry but I wasn't ready so they increased the dosage of the medication and I was good on that for another year (did have pain on and off again). Then the pain was back again with no relief with another increase of medication. They also added tegretol and the combination of medications were making me sick and my quality of life was being interferred with so I opted for the surgery. I had the microvascular decompression done June 2008 and so far so good, no pain. Was stated that the ninth cranial nerve was being compressed by a blood vessel.

Good luck and I hope your brother finds relief.

The doctors told me the surgery was good for at least 15years. I will take what I can get.


MaryAnn

[dr_simran]

Hello Shyambgupta ,

Conservative treatment with medicines and nerve block is usually given to patients with glosso pharyngeal neuralgia.The prescription given by your physician is correct.When the drugs are ineffective,surgery is done  to decompress the nerve from a pulsating artery and may be necessary. If pain is restricted to the pharynx, surgery can be restricted to the extracranial part of the nerve. If pain is widespread, surgery must involve the intracranial part of the nerve.You should go for surgical intervention if all the conservative treatments fail to give results.

Refer http://www.merck.com/mmpe/sec16/ch219/ch219j.html
Best