Neuralgia of the Glossopharyngeal Nerve in a Patient with Posttonsillectomy Scarring: Recovery after Local Infiltration of Procaine—Case Report and Pathophysiologic DiscussionReport as inadecuate




Neuralgia of the Glossopharyngeal Nerve in a Patient with Posttonsillectomy Scarring: Recovery after Local Infiltration of Procaine—Case Report and Pathophysiologic Discussion - Download this document for free, or read online. Document in PDF available to download.

Case Reports in Neurological Medicine - Volume 2015 2015, Article ID 560546, 5 pages -

Case Report

Department of Neural Therapy, IKOM, University of Bern, 3010 Bern, Switzerland

Department of Neurology, University Hospital of Bern, 3010 Bern, Switzerland

Received 28 February 2015; Accepted 6 April 2015

Academic Editor: Paola Sandroni

Copyright © 2015 L. Fischer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We describe a patient with a three-year history of severe progressive left-sided glossopharyngeal neuralgia GPN that failed to adequately respond to various drug therapies. The application of lidocaine spray to the posterior pharyngeal wall provided no more than short-term relief. Apart from a large hypertrophic tonsillectomy scar on the left side all clinical and radiologic findings were normal. In terms of therapeutic local anaesthesia, the hypertrophic tonsillectomy scar tissue was completely infiltrated with the local anaesthetic LA procaine 1%. The patient has been almost completely pain-free ever since, and the lidocaine spray is no longer needed. Six weeks after the first treatment a repeat infiltration of the tonsillectomy scar led to the complete resolution of all symptoms. The patient has become totally symptom-free without the need to take any medication now for two and a half years. This is the first report of a successful therapeutic infiltration of a tonsillectomy scar using an LA in a patient with GPN that has been refractory to medical treatment for several years. A possible explanation may be that the positive feedback loop maintaining neurogenic inflammation is disrupted and “sympathetically maintained pain” resolved by LA infiltration.





Author: L. Fischer, S. M. Ludin, K. Puente de la Vega, and M. Sturzenegger

Source: https://www.hindawi.com/



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