Thombansen E, Menges M M, Thimme W
I. Innere Abteilung des Humboldt-Krankenhauses, Berlin.
Dtsch Med Wochenschr. 1992 Jun 12;117(24):941-4. doi: 10.1055/s-2008-1062395.
Eleven years after treatment of a tonsillar carcinoma by neck dissection, chemotherapy and radiotherapy, a now 26-year-old man had several syncopes, all preceded by burning pain in the area of the left ear with radiation to the throat and left tonsil. ECG monitoring revealed 3 degrees atrioventricular block with a slow idioventricular rhythm (34/min), as well as an asystole lasting 13 seconds. There were renewed syncopes even after pacemaker implantation. 24-hour blood pressure monitoring recorded pressures of 65/50 mm Hg, coinciding with symptoms of pain and dizziness. Being diagnosed as having glossopharyngeal neuralgia with cardiovascular involvement he was given carbamazepine, 400 mg three times daily, but without improvement. Because of this treatment failure the glossopharyngeal nerve was surgically divided, with partial but not complete regression of the symptoms. The patient declined the suggested further bilateral division of the upper vagal branches.
一名扁桃体癌患者在接受颈部清扫术、化疗和放疗11年后，现年26岁，出现了几次晕厥，每次晕厥前左耳区域都会出现灼痛，并放射至咽喉和左侧扁桃体。心电图监测显示三度房室传导阻滞，伴有缓慢的心室自主节律（34次/分钟），以及一次持续13秒的心脏停搏。即使植入起搏器后仍再次出现晕厥。24小时血压监测记录到血压为65/50毫米汞柱，同时伴有疼痛和头晕症状。被诊断为伴有心血管受累的舌咽神经痛后，给他服用卡马西平，每日三次，每次400毫克，但症状并无改善。由于这种治疗失败，对舌咽神经进行了手术切断，症状部分但未完全缓解。患者拒绝了建议的进一步双侧切断迷走上支的治疗。
