Carrat X, François J M, Houliat T, Bertrand B, Devars F, Traissac L
CHU Pellegrin Tripode, Clinique ORL, Bordeaux, France.
Rev Laryngol Otol Rhinol (Bord). 1996;117(2):137-40.
Cases of glossopharyngeal neuralgia are relatively rare, and are occasionally secondary to an upper cervical carcinomatous invasion. The combination with syncopal episodes suggests the creation of a reflex pathway between the glossopharyngeal nerve and the vagus nerve by connections between the bulbar nuclei. The fact that the syncopal episode is systematically preceded by a neuralgic crisis enables its differentiation from other active vasomotor phenomena. Treatment is based essentially on pain-killers and occasionally, in the event of escape, by a neurosurgical resection of the root of the glossopharyngeal nerve and of the upper part of the vagus nerve. In the light of two recent cases, the authors recall the therapeutic management and the physiopathological mechanism of this particular form of neuralgia.
舌咽神经痛病例相对罕见,偶尔继发于上颈部癌性浸润。与晕厥发作合并提示通过延髓核之间的连接在舌咽神经和迷走神经之间形成了反射通路。晕厥发作总是在神经痛发作之前发生,这一事实使其能够与其他活动性血管舒缩现象相鉴别。治疗主要基于止痛药,偶尔在治疗无效时,通过神经外科手术切除舌咽神经根和迷走神经上部。鉴于最近的两个病例,作者回顾了这种特殊形式神经痛的治疗处理和生理病理机制。