title: Vagoglossopharyngeal neuralgia revealed through predominant digestive vagal manifestations. Case report and literature review.
abstract: Vagoglossopharyngeal neuralgia is a rare pathology whose atypical forms, dominated by syncopal manifestations, are still rarer. Although the territory of the vagus nerve involves, beyond the cardiovascular system, the respiratory and the digestive systems, there is no report in literature of atypical forms other than syncopal. Therefore, the authors were prompted to report the case of a patient whose vagoglossopharyngeal neuralgia was predominantly revealed by digestive symptoms. A 58-year-old patient presented with stereotypical severe digestive disturbances including nausea, vomiting and diarrhoea. High definition cranial MRI showed a neurovascular conflict between the posterior inferior cerebellar artery and the IXth and Xth nerves, on the right side. A microsurgical decompression was carried out which confirmed the vascular compression and successful transposition of the artery. One year after the surgery, the patient was free from all painful and digestive symptoms. A survey of the literature did not find any reference to digestive symptoms together with the neuralgia; only a syncopal type of cardiac symptoms related to the parasympathetic nervous system were described. The hypothesis was that the revealing digestive symptoms are linked to a similar parasympathetic mechanism, implying the visceral component of the Xth cranial nerve.
authors.affiliation: Service de neurochirurgie, centre hospitalier universitaire Nord, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France. Electronic address: pierreantherieu@icloud.com.
authors.forename: P
authors.initials: P
authors.lastname: Antherieu
authors.affiliation: Service de neurochirurgie, centre hospitalier universitaire Nord, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France.
authors.forename: F
authors.initials: F
authors.lastname: Vassal
authors.affiliation: Clinique Breteche, 3, rue de la Béraudière, BP 54613, 44046 Nantes cedex 1, France.
authors.forename: M
authors.initials: M
authors.lastname: Sindou
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D002531:Cerebellum / Q000098:blood supply; D003951:Diagnostic Errors; D003967:Diarrhea / Q000209:etiology*; D005157:Facial Pain / Q000188:drug therapy / Q000209:etiology; D005260:Female; D020435:Glossopharyngeal Nerve Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D061145:Microvascular Decompression Surgery; D008875:Middle Aged; D009325:Nausea / Q000209:etiology*; D009408:Nerve Compression Syndromes / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D059906:Neuroimaging; D011602:Psychophysiologic Disorders / Q000175:diagnosis; D020421:Vagus Nerve Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D014839:Vomiting / Q000209:etiology*
chemical_list: D000700:Analgesics
keywords: Atypical vagoglossopharyngeal neuralgia; Compression neurovasculaire; Digestive clinical presentation; Décompression vasculaire microchirurgicale; Hyperstimulation vagale; Manifestations digestives; Microvascular decompression; Neurovascular compression; Névralgie vagoglossopharyngienne atypique; Vagal stimulation