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Have glossopharyngeal neuralgia, taking Gabapentin, pain while swallowing. Can you suggest what to do?

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I have been diagnosed with glossopharyngeal neuralgia since a month ago. Before been diagnosed I was in the hospital for 8 days because I could barely eat and lost about 16 lbs in 12 days, I was getting very weak and was slowly starving to death. Right now I am taking gabapentin 600mg 3 times a day plus anti-depresants, and axiety pills. I still have pain and have to be careful when swallowing, if by mistake I swalllow from the left side I have extreme pain, I experience so many pain episodes a day that eating has became a trauma itself. Anything that touches the left tonsil triggers extreme pain. I am 36 years old. I feel like my life has become a living hell. My primary doctor is only referring me to the pain specialist and not suggesting surgery. How long is this going to go before she reffers me for surgery. I read alot about my condition and concluded that surgery is the best solution. I am becoming more and more depressed as the days go by. There are days that I wish I didn't have to eat to survive. Can you please suggest what to do?
Posted Tue, 22 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 26 hours later

Thank you for your query.

1. Have you been given a trial with Carbamazepine (Tegretol) and Amitriptyline (Tryptomer) ?

2. You should have a CT & MRI Neck with contrast to look for treatable causes such as an Elongated Styloid Process (Eagle's Syndrome), Vascular compression of the nerve roots, any mass pressing upon the nerve along it's course. Microvascular decompression is successful in such cases.

3. Local anesthesia and nerve blocks on the left side can be used to confirm the benefit of surgery. You have already identified the left tonsil area as the trigger zone.

4. Chemical ablation or Radio-frequency ablation of the offending nerve fibers may be done.

5. The possibility of using a nerve stimulator may be considered as against surgery. Surgical ablation causes a other side effects such as loss or altered sensations in the throat and tongue, inappropriate carotid stimulation and so on.

I hope that I have answered your query. If you have any further questions I will be available to answer them.

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