Microvascular decompression for glossopharyngeal neuralgia. A personal 118 cases serie from Latin America. Glossopharyngeal neuralgia (GPN) is a craniofacial pain syndrome described as electrical discharges in the territory of the IX cranial nerve. A very rare neurovascular compression syndrome/cranial nerve HDS. Incidence 0.2–0.7/100,000 h/year. Misdiagnosis TN (V3). The MVD/MSD is a non-destructive technique focused on nerve isolation. Information about short and long-term efficacy of MVD for GPN is scarce. In our database, from 6 years 10 months we attended 2.248 diagnosis cases of HDS, 118 cases with some type of GPN, 40 simple and 78 combined type, and 34 underwent to MVD in our clinic. Results, we reach pain relief (88%), and poor result due to residual pain, not controlled with medication (5,9%); mortality rate cero. As an effective and safe procedure, minimally invasive MSD should be the first choice as a treatment for GPN, allowing good and excellent relief of glossopharyngeal neuropathic pain in most cases. Neurologia Segura Medical Center

1. Mauro Segura, MD, PhD.
Adriana Fernanda Segura Zenón, María Nayeli Rojas Pedroza,Yael Rodrigo Torres Torres,
Alejandro GonzálezSilva, Aarón GiovanniMunguía Rodríguez.
Neurología SeguraMedicalCenter,Morelia,Michoacán,México.
Investigación
Segura
Microvascular decompression for glossopharyngeal
neuralgia. A personal 118 cases serie
Miami, Florida, November 22th, 2022

2. • Glossopharyngeal neuralgia (GPN) is a craniofacial pain
syndrome described as electrical discharges in the territory of
the IX cranial nerve.
• A very rare neurovascular compression syndrome/cranial
nerve HDS.
• Incidence 0.2–0.7/100,000 h/year.
• Misdiagnosis TN (V3).
• The MVD/MSD is a non-destructive technique focused on
nerve isolation. Information about short and long-term
efficacy of MVD for GPN is scarce.
Introduction
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3. January 2016 October 2022
2248
Cases of HDS
118
Cases of GPN
40
Simple
78
Combined
34
MVD
Method
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5. Age at MVD
x̄ = 55.5 y
Evolution of symptoms
x̄ = 7.9 y
Results
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6. 19 cases (56%) 15 cases (44%)
BMI 26.1
BMI 24.2
Results Male
Female
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7. 19 cases
(56%)
15 cases
(44%)
Right side Left side
Results
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8. Results
Triggers Comorbidities
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Tongue base
movement
100%
Pressure
42%
Cold
38%
12.5% 12.5%
DM2
71%
SAH
58%
Negated
41%
Others
33%
DM2=Diabetes Mellitus
SAH = Systemic Arterial Hypertension
DLP= Dyslipidemia
HT = Hypothyroidism
DLP
8%
HT
8%

9. Vascular and histopatological findings
Culprit vessel Arachnoiditis
Viscous
Fibrosis
Calcification
PICA
AICA
VA
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10. Immediate transient
complications
Headache
Dizziness
Nausea
Mild postoperative
complications
1 CSF leak (4%)
5 Transient facial
palsy (20.8%)
Cough (4%)
Dysphonia (4%)
Complications
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Mortality rate
0%

11. Complementary radiofrecuency
Lost follow-up
2 cases (5.9%)
Outcome
No pain
No medication
Mild pain
No medication
Moderate pain
Controlled with
medication
Residual pain
Not controlled
with medication
22
(64.7%)
4
(11.7%)
2
(5.9%)
4
(11.7%)
Outcome
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Pain relief (88%)

12. As an effective and safe procedure, minimally invasive MSD should be the first
choice as a treatment for GPN, allowing good and excellent relief of
glossopharyngeal neuropathic pain in most cases.
Conclusion
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