A Bone-Breaking Case of Syncope Due to Glossopharyngeal Neuralgia

Christina Austin, Keerthana Karumbaiah, Bassam Omar


Glossopharyngeal neuralgia is an uncommon cause of intense facial pain, and is rarely associated with syncope. We present a patient with malignant syncope precipitated by glossopharyngeal neuralgia (GPN), who sustained lower extremity fractures. A 64-year-old Caucasian female with hypertension, diabetes mellitus type 2 and dyslipidemia, presented to the emergency department (ED) after a witnessed syncopal event. Over the preceding 9 months, she experienced multiple syncopal episodes triggered by neck pain, and was diagnosed with GPN by an ENT specialist. She reported a severe, stabbing pain in the right side of her neck prior to the event. Her vital signs and physical examination were unremarkable, except for bilateral leg tenderness. Laboratory data were within normal limits. Electrocardiogram revealed normal sinus rhythm, a rate of 72 beats per minute (BPM), and otherwise normal. Lower extremity X-rays revealed bilateral non-displaced fibular fractures. In the ED, she sustained another syncopal event, and bradycardia with transient heart rates as low as 22 BPM were documented. A temporary transvenous pacemaker was placed. She required pacing repeatedly for repeated bradycardic episodes preceded by right-sided neck pain. She was started on carbamazepine, without complete resolution of her symptoms on escalating doses. Due to recurrent bradycardia with frequent neck pains, requiring temporary pacing, an MRI-compatible permanent pacemaker was placed, to allow for further MRI recommended by neurology service. At 8-week follow-up, she had fully recovered from her neuralgic pain and fractures, without further syncope. This case emphasizes the potentially serious morbidity of GPN-induced syncope and importance of a prompt clinical diagnosis and treatment.

J Med Cases. 2014;5(8):459-462
doi: http://dx.doi.org/10.14740/jmc1875w


Glossopharyngeal neuralgia; Syncope; Bradycardia; Pacemaker; Bone fracture

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.journalmc.org   editorial contact: editor@journalmc.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.