Glossopharyngeal neuralgia.

A review is presented of the clinical features of glossopharyngeal neuralgia, as analysed from 304 reported instances. The sex-ratio of the condition is equal, the peak-age at onset is between 40 and 60 yrs, and left-side involvement predominates in females. The clinical features are detailed in 18 specific items. In a review of the aetiology it is argued that the so-called "idiopathic" type of IXth nerve neuralgia (which, upon careful analysis, may still rest upon either an obscure tumor or infection or elongated styloid process) should be primarily attributed to vascular elongation and looping ("Jannetta mechanism"). The cardiovascular type of the neuralgia, with bradycardia, or asystole and convulsions or coma, receives special emphasis. The differential diagnosis, particularly in view of the not-infrequently occurring combination with trigeminal neuralgia, is set out briefly.