Idiopatic glossopharyngeal neuralgia (GPN) is characterized by sharp paroxysmal pain in teritorry of tongue base, tonsil, palate and ear. Incidence is in comparison with trigeminal neuralgia rare - 0.7/100 000/ear.
Diagnosis is based on history, clinical exam and MRI (neurovascular conflict between PICA and IX nerve). Initial therapy is conservative medical treatment.
In its failure surgical microvascular decompresion using retrosigmoideal craniotomy is the best choice. An alternative treatment in polymorbid and old patients is Leksell Gama Knife.
Authors present 46year old women with 7 years history of GPN who was succesfully treated by microvascular decompression. Pain disappeared completely (BNI scale 1).
Following discussion consider history of GPN treatment and current therapy alternatives.