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Jugular foramen schwannoma presenting with glossopharyngeal neuralgia syncope syndrome

Published online by Cambridge University Press:  06 July 2010

Y Saman ,
D Whitehead  and
M Gleeson
Y Saman
Affiliation:
Neuro-otology Department, National Hospital for Neurology and Neurosurgery, London, UK
D Whitehead
Affiliation:
Department of ENT Surgery, Guy's Hospital, London, UK
M Gleeson*
Affiliation:
Department of ENT Surgery, Guy's Hospital, London, UK Institute of Neurology, University College London, Guy's, Kings and St Thomas' Hospitals, London, UK
*
Address for correspondence: Professor Michael Gleeson, Neuro-otology Department, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK. E-mail: [email protected]
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Abstract

Introduction:

Jugular foramen schwannomas are rare skull base tumours which typically have a variable clinical presentation. Glossopharyngeal syncope syndrome is an unusual clinical presentation; in the following case report, it was the sole presentation of an extracranial jugular foramen tumour.

Methods:

The presentation of a patient with glossopharyngeal neuralgia syncope syndrome is reviewed and the pathophysiology, clinical features and treatment discussed.

Results:

A 45-year-old woman presented with unilateral throat pain, bradycardia and hypotension leading to episodes of impaired consciousness when lying on her left side or turning her head to the left. Imaging detected a left-sided extracranial jugular foramen schwannoma. The tumour was excised, and the patient had no more syncopal attacks.

Conclusion:

Glossopharyngeal neuralgia syncope syndrome can be the sole presentation of a jugular foramen schwannoma. Although this syndrome may be treated with anti-dysrhythmic drugs, cardiac pacing or nerve section, in the presented patient excision of the jugular foramen schwannoma was successful in preventing further episodes of syncope.

Keywords

Glossopharyngeal Nerve DiseasesCranial Nerve NeoplasmsSyncopeNeurilemmomaSkull Base Neoplasms
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 12 , December 2010 , pp. 1305 - 1308
Copyright
Copyright © JLO (1984) Limited 2010

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References

1Tan, LC, Bordi, L, Symon, L, Cheesman, AD. Jugular foramen neuromas: a review of 14 cases. Surg Neurol 1990;34:205–11CrossRefGoogle ScholarPubMed
2Maniglia, AJ, Chandler, JR, Goodwin, WJ Jr, Parker, JC JrSchwannomas of the parapharyngeal space and jugular foramen. Laryngoscope 1979;89:1405–14CrossRefGoogle ScholarPubMed
3Franklin, DJ, Moore, GF, Fisch, U. Jugular foramen peripheral nerve sheath tumors. Laryngoscope 1989;99:1081–7CrossRefGoogle ScholarPubMed
4Kaye, AH, Hahn, JF, Kinney, SE, Hardy, RW Jr, Bay, JW. Jugular foramen schwannomas. J Neurosurg 1984;60:1045–53CrossRefGoogle ScholarPubMed
5Chalmers, AC, Olson, JL. Glossopharyngeal neuralgia with syncope and cervical mass. Otolaryngol Head Neck Surg 1989;100:252–5CrossRefGoogle ScholarPubMed
6Worth, PF, Stevens, JC, Lasri, F, Brew, S, Reilly, MM, Mathias, CJ et al. Syncope associated with pain as the presenting feature of neck malignancy: failure of cardiac pacemaker to prevent attacks in two cases. J Neurol Neurosurg Psychiatry 2005;76:1301–3CrossRefGoogle Scholar
7Kim, SS, Lal, R, Ruffy, R. Bradycardic and vasodepressor syncope secondary to glossopharyngeal neuralgia from hypopharyngeal tumor. Am Heart J 1985;109:1101–2CrossRefGoogle ScholarPubMed
8Dykman, TR, Montgomery, EB Jr, Gerstenberger, PD, Zeiger, HE, Clutter, WE, Cryer, PE. Glossopharyngeal neuralgia with syncope secondary to tumor. Treatment and pathophysiology. Am J Med 1981;71:165–70CrossRefGoogle ScholarPubMed
9Ferrante, L, Artico, M, Nardacci, B, Fraioli, B, Cosentino, F, Fortuna, A. Glossopharyngeal neuralgia with cardiac syncope. Neurosurgery 1995;36:58–63CrossRefGoogle ScholarPubMed
10Esaki, T, Osada, H, Nakao, Y, Yamamoto, T, Maeda, M, Miyazaki, T et al. Surgical management for glossopharyngeal neuralgia associated with cardiac syncope: two case reports. Br J Neurosurg 2007;21:599–602CrossRefGoogle ScholarPubMed
11Alpert, JN, Armbrust, CA, Akhavi, M, Stamatiou, ES, Killian, JM, De Shazo, M. Glossopharyngeal neuralgia, asystole and seizures. Arch Neurol 1977;34:233–5CrossRefGoogle ScholarPubMed
12Al-Ubaidy, SS, Bakeen, G. Paroxysmal glossopharyngeal neuralgia associated with cardiac arrest. Br J Oral Surg 1974;11:243–5CrossRefGoogle ScholarPubMed
13Taylor, PH, Gray, K, Bicknell, PG, Rees, JR. Glossopharyngeal neuralgia with syncope. J Laryngol Otol 1977;91:859–68CrossRefGoogle ScholarPubMed
14Rushton, JG, Stevens, JC, Miller, RH.Glossopharyngeal (vagoglossopharyngeal) neuralgia: a study of 217 cases. Arch Neurol 1981;38:201–5CrossRefGoogle ScholarPubMed
15Katusic, S, Williams, DB, Beard, CM, Bergstralh, E, Kurland, LT. Incidence and clinical features of glossopharyngeal neuralgia, Rochester, Minnesota, 1945–1984. Neuroepidemiology 1991;10:266–75CrossRefGoogle ScholarPubMed
16Gleeson, M, Scott-Brown, WG. Scott-Brown's Otorhinolaryngology: Head and Neck Surgery, 7th edn. London: Hodder Arnold, 2008CrossRefGoogle Scholar
17Weisenburg, T. Cerebello-pontine tumor diagnosis for six years as tic douloureux: the symptoms of irritation of the ninth and twelfth cranial nerves. JAMA 1910;54:1600–4CrossRefGoogle Scholar
18Harris, W. Persistent pain in lesions of the peripheral and central nervous system. Br Med J 1921;2:557–71CrossRefGoogle ScholarPubMed
19Riley, HA, German, WJ, Wortis, H, Herbert, C, Zahn, D, Eichna, L. Glossopharyngeal neuralgia initiating or associated with cardiac arrest. Trans Am Neurol Assoc 1942;68:28–9Google Scholar
20St John, JN.Glossopharyngeal neuralgia associated with syncope and seizures. Neurosurgery 1982;10:380–3CrossRefGoogle ScholarPubMed
21Sobol, SM, Wood, BG, Conoyer, JM. Glossopharyngeal neuralgia-asystole syndrome secondary to parapharyngeal space lesions. Otolaryngol Head Neck Surg 1982;90:16–19CrossRefGoogle ScholarPubMed
22Weinstein, RE, Herec, D, Friedman, JH. Hypotension due to glossopharyngeal neuralgia. Arch Neurol 1986;43:90–2CrossRefGoogle ScholarPubMed
23Barbash, GJ, Keren, G, Korczyn, AD, Sharpless, NJ, Chayen, M, Copperman, Y et al. Mechanisms of syncope in glossopharyngeal neuralgia. Electroencephalogr Clin Neurophysiol 1986;63:231–5CrossRefGoogle ScholarPubMed
24Kjellin, K, Mueller, R, Widen, L. Glossopharyngeal neuralgia associated with cardiac arrest and hypersecretion from the ipsilateral parotid gland. Neurology 1959;9:527–32CrossRefGoogle Scholar
25Reddy, K, Hobson, DE, Gomori, A, Sutherland, GR.Painless glossopharyngeal “neuralgia” with syncope: a case report and literature review. Neurosurgery 1987;21:916–19CrossRefGoogle ScholarPubMed
26Cicogna, R, Bonomi, FG, Curnis, A, Mascioli, G, Bollati, A, Visioli, O et al. Parapharyngeal space lesions syncope syndrome. A newly proposed reflexogenic cardiovascular syndrome. Eur Heart J 1993;14:1476–83CrossRefGoogle ScholarPubMed
27Weiss, S, Baker, JP. The carotid sinus reflex in health and disease: its role in the causation of fainting and convulsions. Medicine (Baltimore) 1933;12:297–354CrossRefGoogle Scholar
28Jamshidi, A, Masroor, MA. Glossopharyngeal neuralgia with cardiac syncope: treatment with a permanent cardiac pacemaker and carbamazepine. Arch Intern Med 1976;136:843–5CrossRefGoogle ScholarPubMed
29Wallin, BG, Westerberg, CE, Sundlof, G. Syncope induced by glossopharyngeal neuralgia: sympathetic outflow to muscle. Neurology 1984;34:522–4CrossRefGoogle ScholarPubMed
30Thomson, JL. Glossopharyngeal neuralgia accompanied by unconsciousness. J Neurosurg 1954;11:511–14CrossRefGoogle ScholarPubMed
31Granit, R, Leksell, L, Skoglund, CR. Fibre interaction in injured or compressed region of nerve. Brain 1944;67:125–40CrossRefGoogle Scholar
32Ishii, T. Glossopharyngeal neuralgia: surgical treatment and electron microscopic findings. Laryngoscope 1976;86:577–83CrossRefGoogle ScholarPubMed
33Johnston, RT, Redding, VJ. Glossopharyngeal neuralgia associated with cardiac syncope: long term treatment with permanent pacing and carbamazepine. Br Heart J 1990;64:403–5CrossRefGoogle ScholarPubMed
34Roa, NL, Krupin, BR. Glossopharyngeal neuralgia with syncope – anesthetic considerations. Anesthesiology 1981;54:426–8CrossRefGoogle ScholarPubMed
35Khero, BA, Mullins, CB. Cardiac syncope due to glossopharyngeal neuralgia. Treatment with a transvenous pacemaker. Arch Intern Med 1971;128:806–8CrossRefGoogle ScholarPubMed
36Giza, E, Kyriakou, P, Liasides, C, Dimakopoulou, A. Glossopharyngeal neuralgia with cardiac syncope: an idiopathic case treated with carbamazepine and duloxetine. Eur J Neurol 2008;15:e38–e39CrossRefGoogle ScholarPubMed
37Savica, R, Lagana, A, Calabro, RS, Casella, C, Musolino, R. Vagoglossopharyngeal neuralgia: a rare case of syncope responding to pregabalin. Cephalalgia 2007;27:566–7CrossRefGoogle ScholarPubMed