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A 51-year-old generally healthy woman presented with a 7-year history of frequent attacks of sharp, stabbing, and shooting pain localized in the throat radiating to the right ear. Attacks were regularly triggered by swallowing and sometimes by straining the voice for periods of days and weeks. Pain paroxysms lasted from 8 to 40 seconds, and continuous series of paroxysms lasted for more than 5 minutes. She had no sensory or motor deficits of the IXth nerve or presence of any other focal neurologic signs. Cranial CT and MR imaging did not reveal any abnormality intracranially at the base of the skull or retropharyngeally. Duplex sonography of the carotid artery was also unremarkable. A diagnosis of glossopharyngeal neuralgia was made and the patient was started on 300 mg carbamazepine (CBZ). This resulted in complete relief at a daily dose of 1,200 mg. …
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