See:

1. http://www.nlm.nih.gov/medlineplus/ency/article/001636.htm for an
overview of what glossopharyngeal neuralgia is;
2. http://www.sma.org.sg/smj/4010/articles/4010ra1.htm for a more
in-depth review.

I know what GNP is. What I want now is detailed information on the
best ways of definitively diagnosing and treating it:

1. What are the recommended methods for definitively determining the
_cause_ of this condition; the value of information provided by each
method; and the approximate cost associated with each method (for
example, X-ray, CAT scan, NMR)? Assume that GNP is in fact diagnosed.
2. What is the general consensus of opinion concerning the main
treatment options and the pros and cons of each approach? (for
example; pain management methods, surgical methods, ...)
3. Which individuals or institutions are considered to be the best
qualified and experienced in (a) diagnosing and (b) treating this
condition? I would like quantitative evidence, for example number of
consulting neurologists, numbers of patients treated per year, what
methods are used, and success ratios; and I need a contact for
enquiries. The institutions may be anywhere in the world, but in order
of preference: South Africa, United Kingdom, continental Europe,
United States.

---

Request for Question Clarification by livioflores-ga on 06 Aug 2003 06:23 PDT

Hi!!

I am researching for your question and I think that I can answer the
questions 1 and 2 related to diagnosis and treatment, but I cannot
complete the question 3 "Which individuals or institutions are
considered to be the best
qualified and experienced in (a) diagnosing and (b) treating this
condition? I would like quantitative evidence, for example number of
consulting neurologists, numbers of patients treated per year, what
methods are used, and success ratios...", I can give you a list of
reputable institutions and/or neurologist; so I need to know if you
accept a partial answer (lowering the price) or may be prefer to split
the question by cancelling this and post 3 or 2 different questions,
giving to each one its own value.
Thank you.
livioflores-ga

---

Clarification of Question by alephomega-ga on 07 Aug 2003 11:45 PDT

The stipulation that the answer to question 3 contain 'quantitative
evidence, for example number of consulting neurologists, numbers of
patients treated per year, what methods are used, and success ratios'
is waived; provided that a list of qualified individuals/institutions
is supplied together with a statement explaining how their
qualification was assessed.

---

Request for Question Clarification by livioflores-ga on 11 Aug 2003 02:29 PDT

Hi alephomega!!

I will not post the answer yet, because i am not sure about if this
info satisfies your needs. So please read this and tell me if I can
post it as the answer, if not please let me know wich are the unclear
or incomplete parts thus I will try to complete them and if the goal
is reached I will be able to claim the prize.


There are several possible causes for the glossopharyngeal neuralgia.
I will sum up the "Pathogenesis" paragraph of the article provided by
you in order to set a background:
"Glossopharyngeal neuralgia usually occurs without any obvious cause.
A thorough physical examination usually does not reveal any
abnormality other than the identification of trigger points.
Radiological examination including CT scans, MRIs, and angiograms will
be normal.
Why then does the nerve go into a state of hyperexcitability causing
“idiopathic glossopharyngeal neuralgia”?
...it became apparent that most of these cases of “idiopathic”
glossopharyngeal neuralgia could be caused by vascular compression of
the glossopharyngeal nerve at the nerve root entry zone, causing a
hyperactive rhizopathy. The implicating vessel is usually the
posterior inferior cerebellar artery (PICA) which frequently also
compresses on the rootlets of the vagus nerve. It is impossible to
image that radiologically...These syndromes are quite effectively
treated by a microvascular decompression procedure of the relevant
vessels...it is important to exclude secondary causes of
glossopharyngeal neuralgia. Any sort of compression or irritation to
the glossopharyngeal nerve can result in neural hyper-excitability and
neuralgia. The most common secondary cause of neuralgia is the Eagle’s
syndrome or styalgia. It is a glossopharyngeal nerve
hyper-excitability syndrome caused by compression of the nerve against
an elongated or fractured styloid process or a calcified stylo-hyoid
ligament.
Other causes of secondary glossopharyngeal neuralgia include:
cerebellopontine angle tumours, parapharyngeal space lesions,
metastasis to petrous temporal bone from breast carcinoma,
post-tonsillectomy, local infection, carcinoma of the parapharyngeal
space, carcinoma of the pharynx, nasopharyngeal carcinoma, posterior
fossa arterio-venous malformation."
From "The Glossopharyngeal Nerve, Glossopharyngeal Neuralgia and the
Eagle’s Syndrome - Current Concepts and Management":
http://www.sma.org.sg/smj/4010/articles/4010ra1.htm


After researching I found that some new things can be added to update
the statements of this nice article.
I will start with the Diagnosis.
In order to rule out secondary causes of the glossopharyngeal
neuralgia several studies may be taken, this studies includes physical
examination, CAT Scan, X-Ray and MRI. None of these is able to
determine if glossopharyngeal neuralgia is caused by vascular
compression of the glossopharyngeal nerve at the nerve root entry
zone.
Several techniques was developed to do this (and more are in the first
states of development), and they are having success diagnosing the
vascular compression of the glossopharyngeal nerve.
One of the most effective techniques is the MRI/MRA (MRI and Magnetic
Resonance Angiography combined)
"Diagnosis & Tests:
Tests should be done to identify an abnormality at the base of the
skull, particularly tumors. These may include X-rays, CAT scan of the
head, and head MRI. Sometimes the MRI may show evidence of
inflammation of the glossopharyngeal nerve.
To determine whether a blood vessel is compressing the nerve, some
pictures of the brain arteries can be obtained using techniques, such
as magnetic resonance angiography (MRA) or conventional angiography
(X-rays of the arteries with a dye).
Occasionally, certain blood tests may be needed when the diagnosis is
not clear, to rule out other causes of peripheral nerve problems
(neuropathy), such as high blood sugar."
"Glossopharyngeal Neuralgia: Diagnosis"
http://www.1uphealth.com/health/glossopharyngeal_neuralgia_diagnosis_tests.html


Once Glossopharyngeal Neuralgia is diagnosed, depending on the cause
of the condition, the appropriate treatment is applied:
"Treatment:
Initial treatment of Glossopharyngeal Neuralgia is medical with
carbamazepine (Tegretol®) and gabapentin (Neurontin®) being the
medications of choice. Unfortunately, these medications are not as
effective for Glossopharyngeal Neuralgia as they are for Trigeminal
Neuralgia. As a result, the majority of patients require Microvascular
Decompression (MVD) which is the only advisable surgical procedure.
Microvascular Decompression:
This procedure involves entering the skull behind the ear and locating
a loop of blood vessel contacting the root entry zone of the 9th
cranial nerve.  The blood vessel is lifted away and padded a safe
distance off the nerve with a Teflon® felt sponge.  The incision is
closed watertight.  Most patients will experience immediate relief of
their pain after this procedure.  The first night post-operatively is
spent in the intensive care unit for observation.  Most people will be
discharged home by the third post-operative day."
From the UCSD Division of Neurosurgery website:
http://www.neurosurgery.ucsd.edu/cnd/glossopharyngeal_neuralgia.htm

See also the followimg pages from the Department of Neurosurgery,
University of Pittsburgh website:
"Glossopharyngeal Neuralgia":
"...We believe MVD for GN is the most effective treatment for this
disorder. Despite the rarity of GN, we have operated upon over 200
patients with throat pain over 80% of whom enjoy immediate excellent
relief."
http://www.neurosurgery.pitt.edu/cranialnerve/disorders/glossneuralgia.html

"Video of MVD Procedure":
http://videoserver.upmc.com/ramgen/neuro/lmimcs.rm

"Center for Cranial Nerve Disorders and Microvascular Surgery ":
"The pioneering work accomplished by University of Pittsburgh faculty
over the past quarter century has established the University of
Pittsburgh Center for Cranial Nerve Disorders and Microvascular
Surgery as the international leader in the management of trigeminal
neuralgia, hemifacial spasm and glossopharyngeal neuralgia. There has
been a significant evolution in the treatment of these conditions over
the past thirty years, now under the direction of Dr. Amin Kassam."
http://www.neurosurgery.pitt.edu/cranialnerve/index.html

Contact and Referral Information for the Center for Cranial Nerve
Disorders and Microvascular Surgery:
-For Appointments:
Debbie McHugh
Appointment Secretary
(412) 647-6778
mchughdl@upmc.edu 
-For General Information:
Lois E. Burkhart, RN
Nurse Coordinator
(412) 647-6776
burkhartle@upmc.edu 
-Address:
UPMC Presbyterian, Suite B-400 
200 Lothrop Street 
Pittsburgh, PA 15213
-Telephone:
(412) 647-6778 or (412) 647-6776
-Fax:
(412) 647-0989

If you want to arrange a consultation with surgeons of this Centre,
please visit the following page:
"How to Arrange a Consultation and What to Expect Once in Pittsburgh":
http://www.neurosurgery.pitt.edu/cranialnerve/consultation.html


There are another treatment, the rhyzotomy, you can read about it at
the following page from the Centre for Cranial Nerve Disorders,
Winnipeg, University of Manitoba, Health Sciences Centre:
"TREATMENTS FOR GPN"
http://www.umanitoba.ca/centres/cranial_nerves/glossopharyngeal_neuralgia/treatments.html


Regrading to the list of reputable institutions and/or neurologist, I
select the institutions and individuals that have contributed with
research about this condition or have a good reputation in this field.
I found the following:

South Africa:
"The South African Society of Otorhinolaryngology Head and Neck
Surgery":
One of the members of the Executive Committee of this society has
claimed the following:
"I am an ENT Surgeon and recently had a patient with glossopharyngeal
neuralgia. I will be approaching the transection of the nerve through
a simple tonsillectomy. Once the fibres of the superior and middle
constrictors are identified, the nerve will be seen ermerging between
them. If cut at this level a vast majority of patients will recover.
dr. shanil ramjettan <sramjet@iafrica.com>
durban, south africa "
CONTACT DETAILS: The ENT official postal address
PO BOX 751191
Garden View
South Africa
2047
Tel 27-11-6226314
fax 27-11-6167780
bryanm@iafrica.com 


Dr Roger L. Melvill:
212 Constantiaberg
Medi-Clinic
Burnham Road
Plumstead, 7800
Cape Town
South Africa
Telephone
+27 (21) 7974330
Facsimile
+27 (21) 7622750
email: melvillr@iafrica.com
See his webpage "The Neurosurgery SA On Line Website":
http://www.neurosurgery.co.za/index.html


Europe:
United Kingdom:
Department of Neurosurgery, Frenchay Hospital, Frenchay, Bristol, UK:
Phone +44 117 970 1212
Email: nitin.patel@neurosurgery.uk.net
http://www.neurosurgery.uk.net/index.php

"CONSULTANT NEUROSURGEONS" page:
http://www.neurosurgery.uk.net/consultants.php


You can also contact the "Trigeminal Neuralgia Association UK"
PO Box 413 
Bromley
BR2 9XS
England
Available Contact Numbers
Head Office: 020 8462 9122 
Visit this page to Contact any Member of the Executive Committee at
the Trigeminal Neuralgia Association UK:
http://www.tna.org.uk/modules.php?name=Contact



France:
Groupe Hospitalier Pitié-Salpétrière, Paris
Directeur  Mme Anne-Marie ARMANTERAS de SAXCE 
Adresse  47-83, boulevard de l'Hôpital
75 PARIS 13ème  
Adresse postale    47-83, boulevard de l'Hôpital
75651 PARIS Cedex 13  
Téléphone  01 42 16 00 00 
Hôpital de  Hôpital d'aigus, soins de suite et de réadaptation, soins
de longue durée
http://www.ap-hop-paris.fr/structure/hopital.asp?hopital=066

SERVICE :  NEURO-CHIRURGIE     
CHEF DE SERVICE  Pr Rémy VAN EFFENTERRE
Tel : 01 42 16 34 06
Fax : 01 42 16 33 41 
http://www.ap-hop-paris.fr/structure/service.asp?hopital=066&service=0033

Doctors from this service have published the following article:
"Glossopharyngeal neuralgia associated with a vascular loop
demonstrated by magnetic resonance imaging.
Boch AL, Oppenheim C, Biondi A, Marsault C, Philippon J. 
We report two cases of glossopharyngeal neuralgia associated with a
vascular loop of the postero-inferior cerebellar artery, diagnosed by
magnetic resonance imaging. Reviewing the literature, we found this to
be the first report of a magnetic resonance-validated vascular
abnormality related to such a condition. One patient was cured by
surgical decompression, confirming the role of the abnormal vessel in
the pain. As with trigeminal neuralgia, a possible vascular etiology
should be considered in glossopharyngeal neuralgia."


USA:
The most recommended is the mentioned Center for Cranial Nerve
Disorders and Microvascular Surgery of the University of Pittsburg.
http://www.neurosurgery.pitt.edu/cranialnerve/contact.html


UCSD Division of Neurosurgery:
Providing surgical evaluation, pre-operative, operative, and
post-operative care for disorders of the brain, spine, and peripheral
nerves.
UCSD Medical Center
Division of Neurosurgery, Mailcode 8893
200 West Arbor Drive
San Diego, CA 92103-8893
(619) 543-5540 office
(619) 543-2769 fax
email Maryellen McLaughlin at: mmclaughlin@ucsd.edu
http://www.neurosurgery.ucsd.edu/


Jho Institute for Minimally Invasive Neurosurgery:
Director: Hae-Dong Jho, M.D., Ph.D.
Professor of Neurosurgery
Drexel University School of Medicine
(previously MCP-Hahnemann Medical School)
Allegheny General Hospital
http://drjho.com/index.htm

Address JHO Institute for Minimally Invasive Neurosurgery
7th Floor, Snyder Pavilion
Allegheny General Hospital
320 East North Avenue
Pittsburgh, PA 15212-4772 
Manager:  Robin A. Coret
e-mail : rcoret@DrJho.com
Tel : (412) 359-6110
Fax : (412) 359-8339
Contact Dr. Jho via e-mail  DrJho@DrJho.com 
Visit this page for more info:
"Trigeminal Neuralgia, Dr. Jho's Endoscopic Micro-Vascular
Decompression":
http://drjho.com/tic_surgery_or_trigeminal_neuralgia_surgery.htm


See also the following organizations:
American Chronic Pain Association (ACPA)
P.O. Box 850 
Rocklin, CA 95677-0850 
ACPA@pacbell.net 
http://www.theacpa.org
Tel: 916-632-0922 800-533-3231 
Fax: 916-632-3208 

National Chronic Pain Outreach Association (NCPOA)
P.O. Box 274 
Millboro, VA 24460 
ncpoa@cfw.com 
http://www.chronicpain.org
Tel: 540-862-9437 
Fax: 540-862-9485 



 This research took me a lot of time for learning about the
Glossopharyngeal Neuralgia and taking conclusions. Please respond to
this request, I will be waiting for your response.

Best regards.
livioflores-ga

---

Clarification of Question by alephomega-ga on 11 Aug 2003 12:48 PDT

Hi livioflores,

First class. Post as the answer and you will get your five stars.

With many thanks,
alephomega

Hello alephomega!!

It is always a pleasure for me to know that the asker find my work
helpful. Thank you for the good opinion given to my proposed answer.
Here I will transcribe the answer:

There are several possible causes for the glossopharyngeal neuralgia.
I will sum up the "Pathogenesis" paragraph of the article provided by
you in order to set a background:
"Glossopharyngeal neuralgia usually occurs without any obvious cause.
A thorough physical examination usually does not reveal any
abnormality other than the identification of trigger points.
Radiological examination including CT scans, MRIs, and angiograms will
be normal.
Why then does the nerve go into a state of hyperexcitability causing
“idiopathic glossopharyngeal neuralgia”?
...it became apparent that most of these cases of “idiopathic”
glossopharyngeal neuralgia could be caused by vascular compression of
the glossopharyngeal nerve at the nerve root entry zone, causing a
hyperactive rhizopathy. The implicating vessel is usually the
posterior inferior cerebellar artery (PICA) which frequently also
compresses on the rootlets of the vagus nerve. It is impossible to
image that radiologically...These syndromes are quite effectively
treated by a microvascular decompression procedure of the relevant
vessels...it is important to exclude secondary causes of
glossopharyngeal neuralgia. Any sort of compression or irritation to
the glossopharyngeal nerve can result in neural hyper-excitability and
neuralgia. The most common secondary cause of neuralgia is the Eagle’s
syndrome or styalgia. It is a glossopharyngeal nerve
hyper-excitability syndrome caused by compression of the nerve against
an elongated or fractured styloid process or a calcified stylo-hyoid
ligament.
Other causes of secondary glossopharyngeal neuralgia include:
cerebellopontine angle tumours, parapharyngeal space lesions,
metastasis to petrous temporal bone from breast carcinoma,
post-tonsillectomy, local infection, carcinoma of the parapharyngeal
space, carcinoma of the pharynx, nasopharyngeal carcinoma, posterior
fossa arterio-venous malformation."
From "The Glossopharyngeal Nerve, Glossopharyngeal Neuralgia and the
Eagle’s Syndrome - Current Concepts and Management":
http://www.sma.org.sg/smj/4010/articles/4010ra1.htm 
 
 
After researching I found that some new things can be added to update
the statements of this nice article.
I will start with the Diagnosis. 
In order to rule out secondary causes of the glossopharyngeal
neuralgia several studies may be taken, this studies includes physical
examination, CAT Scan, X-Ray and MRI. None of these is able to
determine if glossopharyngeal neuralgia is caused by vascular
compression of the glossopharyngeal nerve at the nerve root entry
zone.
Several techniques was developed to do this (and more are in the first
states of development), and they are having success diagnosing the
vascular compression of the glossopharyngeal nerve.
One of the most effective techniques is the MRI/MRA (MRI and Magnetic
Resonance Angiography combined)
"Diagnosis & Tests: 
Tests should be done to identify an abnormality at the base of the
skull, particularly tumors. These may include X-rays, CAT scan of the
head, and head MRI. Sometimes the MRI may show evidence of
inflammation of the glossopharyngeal nerve.
To determine whether a blood vessel is compressing the nerve, some
pictures of the brain arteries can be obtained using techniques, such
as magnetic resonance angiography (MRA) or conventional angiography
(X-rays of the arteries with a dye).
Occasionally, certain blood tests may be needed when the diagnosis is
not clear, to rule out other causes of peripheral nerve problems
(neuropathy), such as high blood sugar."
"Glossopharyngeal Neuralgia: Diagnosis" 
http://www.1uphealth.com/health/glossopharyngeal_neuralgia_diagnosis_tests.html
 
 
Once Glossopharyngeal Neuralgia is diagnosed, depending on the cause
of the condition, the appropriate treatment is applied:
"Treatment: 
Initial treatment of Glossopharyngeal Neuralgia is medical with
carbamazepine (Tegretol®) and gabapentin (Neurontin®) being the
medications of choice. Unfortunately, these medications are not as
effective for Glossopharyngeal Neuralgia as they are for Trigeminal
Neuralgia. As a result, the majority of patients require Microvascular
Decompression (MVD) which is the only advisable surgical procedure.
Microvascular Decompression: 
This procedure involves entering the skull behind the ear and locating
a loop of blood vessel contacting the root entry zone of the 9th
cranial nerve.  The blood vessel is lifted away and padded a safe
distance off the nerve with a Teflon® felt sponge.  The incision is
closed watertight.  Most patients will experience immediate relief of
their pain after this procedure.  The first night post-operatively is
spent in the intensive care unit for observation.  Most people will be
discharged home by the third post-operative day."
From the UCSD Division of Neurosurgery website: 
http://www.neurosurgery.ucsd.edu/cnd/glossopharyngeal_neuralgia.htm 
 
See also the followimg pages from the Department of Neurosurgery,
University of Pittsburgh website:
"Glossopharyngeal Neuralgia": 
"...We believe MVD for GN is the most effective treatment for this
disorder. Despite the rarity of GN, we have operated upon over 200
patients with throat pain over 80% of whom enjoy immediate excellent
relief."
http://www.neurosurgery.pitt.edu/cranialnerve/disorders/glossneuralgia.html
 
"Video of MVD Procedure": 
http://videoserver.upmc.com/ramgen/neuro/lmimcs.rm 
 
"Center for Cranial Nerve Disorders and Microvascular Surgery ": 
"The pioneering work accomplished by University of Pittsburgh faculty
over the past quarter century has established the University of
Pittsburgh Center for Cranial Nerve Disorders and Microvascular
Surgery as the international leader in the management of trigeminal
neuralgia, hemifacial spasm and glossopharyngeal neuralgia. There has
been a significant evolution in the treatment of these conditions over
the past thirty years, now under the direction of Dr. Amin Kassam."
http://www.neurosurgery.pitt.edu/cranialnerve/index.html 
 
Contact and Referral Information for the Center for Cranial Nerve
Disorders and Microvascular Surgery:
-For Appointments: 
Debbie McHugh 
Appointment Secretary 
(412) 647-6778 
mchughdl@upmc.edu  
-For General Information: 
Lois E. Burkhart, RN 
Nurse Coordinator 
(412) 647-6776 
burkhartle@upmc.edu  
-Address: 
UPMC Presbyterian, Suite B-400  
200 Lothrop Street  
Pittsburgh, PA 15213 
-Telephone: 
(412) 647-6778 or (412) 647-6776 
-Fax: 
(412) 647-0989 
 
If you want to arrange a consultation with surgeons of this Centre,
please visit the following page:
"How to Arrange a Consultation and What to Expect Once in Pittsburgh":
http://www.neurosurgery.pitt.edu/cranialnerve/consultation.html 
 
 
There are another treatment, the rhyzotomy, you can read about it at
the following page from the Centre for Cranial Nerve Disorders,
Winnipeg, University of Manitoba, Health Sciences Centre:
"TREATMENTS FOR GPN" 
http://www.umanitoba.ca/centres/cranial_nerves/glossopharyngeal_neuralgia/treatments.html
 
 
Regrading to the list of reputable institutions and/or neurologist, I
select the institutions and individuals that have contributed with
research about this condition or have a good reputation in this field.
I found the following: 
 
South Africa: 
"The South African Society of Otorhinolaryngology Head and Neck
Surgery":
One of the members of the Executive Committee of this society has
claimed the following:
"I am an ENT Surgeon and recently had a patient with glossopharyngeal
neuralgia. I will be approaching the transection of the nerve through
a simple tonsillectomy. Once the fibres of the superior and middle
constrictors are identified, the nerve will be seen ermerging between
them. If cut at this level a vast majority of patients will recover.
dr. shanil ramjettan <sramjet@iafrica.com> 
durban, south africa " 
CONTACT DETAILS: The ENT official postal address 
PO BOX 751191 
Garden View 
South Africa 
2047 
Tel 27-11-6226314 
fax 27-11-6167780 
bryanm@iafrica.com  
 
 
Dr Roger L. Melvill: 
212 Constantiaberg 
Medi-Clinic 
Burnham Road 
Plumstead, 7800 
Cape Town 
South Africa 
Telephone 
+27 (21) 7974330 
Facsimile 
+27 (21) 7622750 
email: melvillr@iafrica.com 
See his webpage "The Neurosurgery SA On Line Website": 
http://www.neurosurgery.co.za/index.html 
 
 
Europe: 
United Kingdom: 
Department of Neurosurgery, Frenchay Hospital, Frenchay, Bristol, UK:
Phone +44 117 970 1212 
Email: nitin.patel@neurosurgery.uk.net 
http://www.neurosurgery.uk.net/index.php 
 
"CONSULTANT NEUROSURGEONS" page: 
http://www.neurosurgery.uk.net/consultants.php 
 
 
You can also contact the "Trigeminal Neuralgia Association UK" 
PO Box 413  
Bromley 
BR2 9XS 
England 
Available Contact Numbers 
Head Office: 020 8462 9122  
Visit this page to Contact any Member of the Executive Committee at
the Trigeminal Neuralgia Association UK:
http://www.tna.org.uk/modules.php?name=Contact 
 
 
 
France: 
Groupe Hospitalier Pitié-Salpétrière, Paris 
Directeur  Mme Anne-Marie ARMANTERAS de SAXCE  
Adresse  47-83, boulevard de l'Hôpital 
75 PARIS 13ème   
Adresse postale    47-83, boulevard de l'Hôpital 
75651 PARIS Cedex 13   
Téléphone  01 42 16 00 00  
Hôpital de  Hôpital d'aigus, soins de suite et de réadaptation, soins
de longue durée
http://www.ap-hop-paris.fr/structure/hopital.asp?hopital=066 
 
SERVICE :  NEURO-CHIRURGIE      
CHEF DE SERVICE  Pr Rémy VAN EFFENTERRE 
Tel : 01 42 16 34 06 
Fax : 01 42 16 33 41  
http://www.ap-hop-paris.fr/structure/service.asp?hopital=066&service=0033
 
Doctors from this service have published the following article: 
"Glossopharyngeal neuralgia associated with a vascular loop
demonstrated by magnetic resonance imaging.
Boch AL, Oppenheim C, Biondi A, Marsault C, Philippon J.  
We report two cases of glossopharyngeal neuralgia associated with a
vascular loop of the postero-inferior cerebellar artery, diagnosed by
magnetic resonance imaging. Reviewing the literature, we found this to
be the first report of a magnetic resonance-validated vascular
abnormality related to such a condition. One patient was cured by
surgical decompression, confirming the role of the abnormal vessel in
the pain. As with trigeminal neuralgia, a possible vascular etiology
should be considered in glossopharyngeal neuralgia."
 
 
USA: 
The most recommended is the mentioned Center for Cranial Nerve
Disorders and Microvascular Surgery of the University of Pittsburg.
http://www.neurosurgery.pitt.edu/cranialnerve/contact.html 
 
 
UCSD Division of Neurosurgery: 
Providing surgical evaluation, pre-operative, operative, and
post-operative care for disorders of the brain, spine, and peripheral
nerves.
UCSD Medical Center 
Division of Neurosurgery, Mailcode 8893 
200 West Arbor Drive 
San Diego, CA 92103-8893 
(619) 543-5540 office 
(619) 543-2769 fax 
email Maryellen McLaughlin at: mmclaughlin@ucsd.edu 
http://www.neurosurgery.ucsd.edu/ 
 
 
Jho Institute for Minimally Invasive Neurosurgery: 
Director: Hae-Dong Jho, M.D., Ph.D. 
Professor of Neurosurgery 
Drexel University School of Medicine 
(previously MCP-Hahnemann Medical School) 
Allegheny General Hospital 
http://drjho.com/index.htm 
 
Address JHO Institute for Minimally Invasive Neurosurgery
7th Floor, Snyder Pavilion 
Allegheny General Hospital 
320 East North Avenue 
Pittsburgh, PA 15212-4772  
Manager:  Robin A. Coret 
e-mail : rcoret@DrJho.com 
Tel : (412) 359-6110 
Fax : (412) 359-8339 
Contact Dr. Jho via e-mail  DrJho@DrJho.com  
Visit this page for more info: 
"Trigeminal Neuralgia, Dr. Jho's Endoscopic Micro-Vascular
Decompression":
http://drjho.com/tic_surgery_or_trigeminal_neuralgia_surgery.htm 
 
 
See also the following organizations: 
American Chronic Pain Association (ACPA) 
P.O. Box 850  
Rocklin, CA 95677-0850  
ACPA@pacbell.net  
http://www.theacpa.org 
Tel: 916-632-0922 800-533-3231  
Fax: 916-632-3208  
 
National Chronic Pain Outreach Association (NCPOA) 
P.O. Box 274  
Millboro, VA 24460  
ncpoa@cfw.com  
http://www.chronicpain.org 
Tel: 540-862-9437  
Fax: 540-862-9485  


Search strategy:
KEYWORDS
"glossopharyngeal neuralgia"
"glossopharyngeal neuralgia" treatment
"glossopharyngeal neuralgia" diagnosis
"glossopharyngeal neuralgia" MRI MRA
glossopharyngeal pain

SEARCH ENGINE
www.google.com


Thank you for the oportunity to answer your interesting questions.
Please feel free to request for all the clarifications that you think
are needed.

Best regards.
livioflores-ga

---

Clarification of Answer by livioflores-ga on 11 Aug 2003 22:33 PDT

Hi again alephomega!!

I want to add a link to some articles that will give you more valuable
info related to the GPN:
Please go to the SpringerLink Homepage:
http://www.springerlink.com

Then in the "Search for" box located at the top of the page type the
words (without quetes) "glossopharyngeal neuralgia", you will lead to
the "SpringerLink - Search Results - Criteria: glossopharyngeal
neuralgia" page. At this page you will see a list with the following
articles:

·Glossopharyngeal Neuralgia Associated with a Vascular Loop
Demonstrated by Magnetic Resonance Imaging (by A.-L. Boch, C.
Oppenheim, A. Biondi, et al.)

·Glossopharyngeal Neuralgia Caused by Adhesive Arachnoid (by H.
Fukuda, M. Ishikawa, N. Yamazoe)

·Microvascular Decompression for Treating Glossopharyngeal Neuralgia
Complicated by Sick Sinus Syndrome (by Y. Nishikawa, M. Suzuki, N.
Kuwata, et al.)

·Possible Role of an Endovascular Provocative Test in the Diagnosis of
Glossopharyngeal Neuralgia as a Vascular Compression Syndrome (by T.
Matsushima, Y. Goto, H. Ishioka, et al.)

·Chiari type I presenting as left glossopharyngeal neuralgia with
cardiac syncope (by Paulo Aguiar, Oswaldo Tella, Carlos Pereira, Fábio
Godinho, Renata Simm)

·Surgical Treatment of Glossopharyngeal Neuralgia as Vascular
Compression Syndrome via Transcondylar Fossa (Supracondylar
Transjugular Tubercle) Approach (by T. Matsushima, Y. Goto, Y. Natori,
et al.)

·Sudden Onset Pharyngeal Pain Associated with Dissecting Vertebral
Artery Aneurysm (Y. Soga, Y. Ito)

If you want to read one of these articles just click on the title of
the one that you want to see and a new page will be showed, just do
another click on the "(Open)Entire Document" button on the right side
of the page.

You have to be instaled the Acrobat Reader software to read the
articles.

If you have troubles with this pages, please let me know and I will
gladly answer your queries.

Best regards.
livioflores-ga

Very carefully and meticulously researched. This researcher took some
trouble to understand the subject and to check what was acceptable.
Although not all of the items asked for could be obtained, it can only
be because the answers were not on the net.