Glossopharyngeal Neuralgia Caused by Diabetes Mellitus:A Case Report

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  • Matsumoto Fumihiro
    Department of Oral Medicine, Institute of Biomedical Sciences, The University of Tokushima Graduate Faculty of Dentistry, Japan
  • Momota Yukihiro
    Department of Oral Medicine, Institute of Biomedical Sciences, The University of Tokushima Graduate Faculty of Dentistry, Japan
  • Takano Hideyuki
    Department of Oral Medicine, Institute of Biomedical Sciences, The University of Tokushima Graduate Faculty of Dentistry, Japan
  • Matsuka Yoshizo
    Department of Stomatognathic Function and Occlusal Reconstruction, Institute of Biomedical Sciences, The University of Tokushima Graduate Faculty of Dentistry, Japan

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  • 糖尿病神経障害と診断された舌咽神経痛の一症例

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Patient: A 35-year-old woman visited the Center for Advanced Dental Health Care, Tokushima University Hospital, because of severe orofacial pain that was precipitated by chewing on food approximately 4 months ago. Two months after onset, she consulted a neighboring dental clinic and was diagnosed with temporomandibular disorders. Her severe pain did not improve with splint therapy. The pain was particularly more severe when eating sour foods. The pain episodes persisted for a few minutes. We considered her sudden, paroxysmal, brief pain to be glossopharyngeal neuralgia（GPN） because of the characteristic pain, and prescribed carbamazepine. Although the magnitude of her severe pain decreased with this medication, it did not completely disappear. Four months after her initial visit, the patient complained of abnormal sensation in her hands, and was advised to get a blood test, which revealed marked hyperglycemia. Accordingly, the patient was diagnosed with type 2 diabetes at the Endocrinology and Metabolism department of Internal Medicine. Subsequently, with appropriate glycemic control her neuropathic pain completely disappeared approximately 1 year later.<br>Discussion: A few studies of GPN caused by diabetes mellitus have been reported. Takahashi et al. reported that patients with GPN due to diabetes were younger than those with a general GPN, and developed bilaterally. Similarly, our present case showed such characteristics. In addition to such findings, because her neuropathic pain completely disappeared with appropriate glycemic control, a definitive diagnosis of paroxysmal neuralgia due to diabetic neuropathy was made.<br>Conclusions: We have described a rare case of GPN caused by diabetes mellitus and acknowledged the importance of careful medical interview of patients with characteristic orofacial pain.

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