Case of vago-glossopharyngeal neuralgia secondary to metastatic oropharyngeal cancer

BMJ Case Rep. 2020 Jun 28;13(6):e232820. doi: 10.1136/bcr-2019-232820.

Abstract

Glossopharyngeal neuralgia (GN) is a rare pain syndrome caused by compression of the glossopharyngeal nerve. It is typically idiopathic and often goes misdiagnosed because of its similarities to trigeminal neuralgia. Vago-glossopharyngeal neuralgia, an even rarer subset of GN, occurs when the pain is accompanied by syncope and/or arrhythmia. Here, we present the case of a 54-year-old man with oropharyngeal cancer that metastasised to areas within his left carotid sheath. He presented with numerous intermittent episodes of pain, accompanied by vagal episodes. While this presentation is similarly described in prior case reports, our case is unique in that the syndrome occurred as a direct sequelae of a metastatic tumour completely encasing the left internal carotid artery.

Keywords: adult intensive care; cranial nerves; pain (neurology).

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / secondary*
  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Artery, Internal / pathology*
  • Diagnosis, Differential
  • Glossopharyngeal Nerve Diseases / etiology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Oropharyngeal Neoplasms / complications*
  • Oropharyngeal Neoplasms / pathology
  • Pain / etiology