Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Background and Aims Glossopharyngeal neuralgia is a rare cranial neuralgia that presents as recurring episodes of shooting sharp pain in the jaw, throat, tongue, and ear. This case report demonstrates a rare treatment of glossopharyngeal neuralgia with peripheral nerve block under ultrasound guidance.

Methods A 69-year-old woman presented with unilateral, transient, piercing pain in the ear, the base of the tongue, tonsillar fossa, posterior pharynx, and submandibular region. It was triggered by chewing, swallowing, talking, yawning, or coughing. During the physical examination, the posterior wall of the ear canal was found to be painful when touched with a Q-tip. Head and neck MRI was unremarkable. She had previously failed to respond to pharmacological treatment. A diagnosis of glossopharyngeal neuralgia was considered. She underwent an ultrasound-guided anesthetic block of the glossopharyngeal nerve, 0.5% lidocaine and 40 mg methylprednisolone were slowly injected under real-time ultrasound guidance.

Results The patient had analgesic effects within 5 minutes of the injection. Following the treatment, the patient experienced just three moderate and short-lived episodes of pain over 24 hours. Subsequently, the patient returned to their baseline without any discomfort. She has not had another flair for three months since the block.

Conclusions Currently, primary glossopharyngeal neuralgia is challenging to treat. Treatment includes carbamazepine, gabapentin, baclofen, or neurosurgical procedures if medication fails. We report the ultrasound-guided glossopharyngeal nerve block as a successful treatment for glossopharyngeal neuralgia. Given the limited efficacy of existing treatments, we urge neurologists and pain physicians to consider the implementation of this intervention as a viable treatment alternative.