Glossopharyngeal neuralgia with repeated cardiac syncope: A case report

BACKGROUND: Glossopharyngeal neuralgia (GPN) is an uncommon craniofacial pain syndrome. Although rare, it is occasionally associated with cardiac syncope, as vago-glossopharyngeal neuralgia (VGPN). CASE DESCRIPTION: We present the case of a 73-year-old man with VGPN misdiagnosed as trigeminal neuralgia. The patient was diagnosed with sick sinus syndrome, and a pacemaker was introduced. However, syncope still recurred. Magnetic resonance imaging revealed a branch of the right posterior inferior cerebellar artery contacting the root exit zone of the right glossopharyngeal and vagus nerves. We diagnosed VGPN due to neurovascular compression and performed microvascular decompression (MVD). The symptoms disappeared postoperatively. CONCLUSION: Diagnosis of VGPN needs appropriate medical interviews and physical examination. MVD is the only curative treatment for VGPN occurring as a neurovascular compression syndrome.