Aldhafeeri Wafa Faisal, Alanazi Rahaf Farhan, Abdullah Jamal, Nazer Abdullrahman
Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Surg Neurol Int. 2024 Apr 19;15:132. doi: 10.25259/SNI_642_2023. eCollection 2024.
This type of pain syndrome occurs suddenly and briefly, beginning unilaterally from one side of the face. Modestly stimulating speech can provoke it, affecting the ear, tongue, throat, and jaw angle. Interestingly, it is the sensory distribution of the auricular and the pharyngeal branches of the cranial nerves IX and X. People have not had a confirmed case of glossopharyngeal neuralgia (GPN), along with oromandibular dystonia (OMD). Nevertheless, usually in the medical literature, this case report supplies information about a patient who has concurrent GPN and OMD.
A 36-year-old male patient presented with a history of sudden onset of increasing electric pains, which were centered in the middle of the forehead to the depth of the throat and accompanied by uncontrolled movements, repetitive tongue protrusions, jaw movements, and recurrent pervasive gagging reflexes. Magnetic resonance imaging showed that a vascular loop of the superior cerebellar and anterior inferior cerebellar artery on the left side had crossed over and compressed those nerves. Decompression surgery in the left glossopharyngeal and trigeminal nerves cured all the symptoms.
The simultaneous occurrence of GPN and OMD is rare, complex, and challenging from the clinician's viewpoint in the management of similar but different pathologies. A detailed history was taken, and a radiological investigation was called to devise a management plan in the context of understanding the pathology of both disorders.
这种疼痛综合征突然发作且持续时间短暂,从面部一侧开始单侧发作。适度刺激说话就可能引发疼痛,影响耳朵、舌头、喉咙和下颌角。有趣的是,它是颅神经IX和X的耳支及咽支的感觉分布区域。此前尚未有舌咽神经痛(GPN)合并口下颌肌张力障碍(OMD)的确诊病例。然而,在医学文献中,本病例报告提供了一名同时患有GPN和OMD患者的相关信息。
一名36岁男性患者,有突发加剧的电击样疼痛病史,疼痛集中在前额中部至喉咙深处,并伴有不受控制的动作、反复伸舌、下颌运动以及反复出现的广泛 gag 反射。磁共振成像显示左侧小脑上动脉和小脑前下动脉的血管袢交叉并压迫了这些神经。对左侧舌咽神经和三叉神经进行减压手术治愈了所有症状。
从临床医生的角度来看,GPN和OMD同时出现较为罕见、情况复杂且在处理相似但不同的病理情况时具有挑战性。通过详细询问病史并进行影像学检查,以便在了解两种疾病病理的背景下制定管理计划。