Correspondence
Headphone Neuralgia
N Engl J Med 1995; 333:1786-1787December 28, 1995
- Article
To the Editor:
Glossopharyngeal neuralgia is an uncommon cause of head or facial pain. A review of the epidemiologic data base at the Mayo Clinic identified only 217 cases in 55 years.1 Trauma is a rare cause of this disorder, but contemporary life can produce trauma from unconventional sources. We report a case of glossopharyngeal neuralgia caused by the use of headphones with hard plastic earpieces.
A 37-year-old woman suddenly had paroxysmal, lancinating pain in the left ear. The pain radiated from the external auditory meatus to the ipsilateral parietal area of the head. Over a period of several hours, it spread to the left shoulder, the neck, and the left side of the pharynx. Yawning, eructation, swallowing, and raising the left arm while driving all triggered the pain. No motor or sensory deficit was noted, and no neurologic abnormalities were found. The pain was partly relieved by nonsteroidal antiinflammatory medication. Without other treatment, it gradually improved and resolved entirely after five days.
An additional history revealed that on the two days before the onset of pain, the patient had worn headphones with hard plastic earpieces that rested in the external auditory canal. The earpieces had been in place for eight hours each day. The patient noted only mild discomfort in the canal while wearing them; she discontinued their use altogether when the symptoms of neuralgia developed.
Glossopharyngeal neuralgia was first described in 1910.2 It shares some characteristics with the more common trigeminal neuralgia but is often milder. In most cases, the cause of glossopharyngeal neuralgia is not found. Vascular diseases, local infection and inflammation, and neoplasms, such as cerebellopontine-angle tumors and tumors of the oropharynx, have resulted in glossopharyngeal neuralgia. Trauma is a rare cause.3
In our patient, local irritation of the extracranial portion of the nerve is presumed to have caused the neuralgia, which was self-limited. As headphones with hard plastic earpieces become more popular, physicians may encounter this disorder more frequently. Similarly shaped objects in the auditory canal, such as stethoscope earpieces and hearing aids, may put patients at risk for glossopharyngeal neuralgia. Traumatic neuralgia produced in this manner should be self-limited after the object is removed, and costly diagnostic and therapeutic maneuvers should be avoidable.
3 ReferencesAnn K. Skelton, M.D.
Robert A. Fried, M.D
Maine Medical Center, Portland, ME 041011
Bruyn GW . Glossopharyngeal neuralgia. Cephalalgia 1983;3:143-157
CrossRef | Web of Science | Medline2
Weisenburg TH . Cerebello-pontile tumor diagnosed for six years as tic douloureux. JAMA 1910;54:1600-16043
Waga S ,Kojima T . Glossopharyngeal neuralgia of traumatic origin. Surg Neurol 1982;17:77-79
CrossRef | Web of Science | Medline
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