Symptoms of lingual neuritis

Many people do not know much about lingual neuritis, which is also a common neuritis disease. When optic neuritis occurs, severe pain often occurs at the root of the tongue and tonsils. Sometimes the pain occurs at different times. It may appear suddenly and stop immediately. It can also cause difficulty in chewing and swallowing. When in pain, it is also easy to have symptoms such as paroxysmal coughing.

Symptoms of lingual neuritis

The typical clinical feature is sudden, severe, knife-like or burning pain in the pharynx, tongue base, and tonsils on one side. The pain may be localized in the pharynx or may radiate to the mandible, external auditory canal, and neck. Occasionally, pain is localized deep in the external auditory canal, which is related to involvement of the tympanic branch of the glossopharyngeal nerve. The pain usually comes on suddenly and lasts for a short time, rarely lasting more than 1 minute.

Swallowing, chewing, and talking may provoke pain. The pain may be accompanied by paroxysmal coughing, pharyngeal spasm, increased salivation, sweating, tearing, tachycardia, low or high blood pressure, and cardiac arrest, which are symptoms of vagus nerve stimulation.

The pain is mostly unilateral and may occasionally coexist with trigeminal neuralgia; bilateral glossopharyngeal neuralgia is rare. Although the pain of primary glossopharyngeal neuralgia is unbearable during attacks, there are no positive physical signs, and the period between attacks is similar to that of normal people. Glossopharyngeal neuralgia rarely has a "trigger point", and the occasional "trigger point" is often in the tonsillar fossa.

Etiology and pathogenesis

The causes of glossopharyngeal neuralgia are also divided into secondary and primary. Intracranial and extracranial tumors in the cerebellopontine angle and its adjacent areas, aneurysms, meningitis, neck trauma, and calcification of the stylohyoid ligament can all stimulate and compress the glossopharyngeal nerve and cause neuralgia. Recently, many scholars believe that glossopharyngeal neuralgia is caused by the vertebral artery or the posterior inferior cerebellar artery and its branches riding over the glossopharyngeal and vagus nerve roots entering the brainstem.

Differential Diagnosis

It is not difficult to make a clinical diagnosis based on the nature and characteristics of the pain attack. If stimulation of the "trigger point" in the pharynx can induce pain, and the pain disappears after local spraying of tetracaine, the disease can be diagnosed. If the throat pain disappears after spraying but the ear pain remains as before, it means that not only glossopharyngeal neuralgia but also the posterior auricular branch of the vagus nerve is affected. If the pain is persistent and accompanied by positive neurological signs, secondary glossopharyngeal neuralgia should be considered and further examination is required.