title: Glossopharyngeal neuralgia in the context of a Chiari type I malformation.
abstract: A 34-year-old woman presented with disabling right-sided glossopharyngeal neuralgia. MRI revealed a Chiari I malformation with an asymmetric herniation of the right tonsil. Surgical inspection of the lower cranial nerves through a suboccipital approach showed no vascular compromise. The patient was pain free for three months before the same symptoms recurred. MRI showed a persisting crowding at the level of the foramen magnum. A second intervention with extension of the suboccipital craniectomy and resection of the right tonsil achieved definitive pain relief. To our knowledge this is the fourth report of a glossopharyngeal neuralgia caused by a Chiari I malformation. Recurrence of the pain after incomplete decompression of the posterior fossa underlines the importance of tonsillectomy in these patients.
authors.affiliation: Department of Neurosurgery, Hospital General Universitario "Gregorio Marañón", Madrid, Spain. doc.fer@gmx.de
authors.forename: Fernando
authors.initials: F
authors.lastname: Ruiz-Juretschke
authors.forename: Roberto
authors.initials: R
authors.lastname: García-Leal
authors.forename: Sara
authors.initials: S
authors.lastname: Garcia-Duque
authors.forename: Teresa
authors.initials: T
authors.lastname: Panadero
authors.forename: Cristina
authors.initials: C
authors.lastname: Aracil
mesh_terms: D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000601:surgery; D019299:Decompression, Surgical; D005260:Female; D020435:Glossopharyngeal Nerve Diseases / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging