Tonsillar pain mimicking glossopharyngeal neuralgia as a complication of vagus nerve stimulation: case report.
An adolescent girl presented with severe, lancinating tonsillar pain exacerbated by swallowing 6 weeks after initiation of left vagus nerve stimulation for intractable epilepsy. Her symptoms mimicked those seen in glossopharyngeal neuralgia and were relieved by temporary cessation of stimulation. Gradual reinstitution of therapy with alteration in stimulus parameters resulted in improved seizure control as well as cessation of pain symptoms. Direct stimulation of the vagus nerve may result in vagoglossopharyngeal neuralgia, which, in this case, was amenable to stimulus modification.
Duhaime
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Division of Neurosurgery, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. duhaime@email.chop.edu
Melamed
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Clancy
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D000293:Adolescent; D003937:Diagnosis, Differential; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D020435:Glossopharyngeal Nerve Diseases / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D009437:Neuralgia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014066:Palatine Tonsil / Q000294:innervation* / Q000503:physiopathology; D014630:Vagus Nerve / Q000503:physiopathology*