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Europace 2003 5(2):149-152; doi:10.1053/eupc.2002.0298
© 2003 by European Society of Cardiology
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CASE REPORT

Glossopharyngeal neuralgia with cardiac syncope treated by glossopharyngeal rhizotomy and microvascular decompression

M. Ozenci1, R. Karaoguz1, C. Conkbayir1, T. Altin1 and Y. Kanpolat2

1Department of Cardiology Ankara, Turkey; 2Department of Cardiology and Neurosurgery School of Medicine, University of Ankara Ankara, Turkey

A glossopharyngeal neuralgia case with cardiac asystole is presented. The sinus mode dysfunction and subsequent syncope with pain appears to be the most important life-threatening symptom in the late period of the disease. Because of cardiac symptoms induced by intense vagal stimulation, this case was considered to be vagoglossopharyngeal neuralgia. Several medical and surgical alternatives have been proposed for its treatment. In the presented case the cause of disease was compression of lower cranial nerves in the right cerebello-pontine angle (CPA) by the vertebro-basilar arterial system. Carbamazepine and pacing were determined ineffective, so the patient was treated surgically by cutting the glossopharyngeal nerve and by decompression of the vagal nerve at the CPA. The sinus arrest and paroxysmal pain attacks disappeared and the patient's life returned to normal.

Key Words: Microvascular decompression, glossopharyngeal neuralgia, vagoglossopharyngeal neuralgia, syncope, pacing

Correspondence: Prof. Dr Metin Ozenci, Or-an Sitesi, 2. Parsel, 20/3 06700, Cankaya-Ankara, Turkey. E-mail: ozenci{at}medicine.ankara.edu.tr


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