Neuralgia refers to a severe sharp pain occurring along the course of a nerve. The Xth cranial nerve is one of twelve pairs of nerves connected with the brain, which provides sensation to the ear, tongue, pharynx, and larynx, and moves muscles of speech and swallowing. The nerve also sends impulses to the heart, lungs, esophagus, stomach, and smooth muscles of visceral organs.

The cause of neuralgia related to the nerve may be unknown. Identified attributing causes may include: injury or irritation to the nerve; nerve root compression by a blood vessel or tumor; viral infections; chronic degenerative diseases such as multiple sclerosis; toxins; and infections.

Signs and symptoms may occur at irregular intervals. Manifestations are characterized by attacks of unilateral, sharp, stabbing, burning pain in the tonsils or posterior pharynx. There may be hypersensitivity to swallowing, talking or touching. These actions provoke new attacks, and may present symptoms including: dysarthria; dysphagia; hoarseness; a lax palate; deviation of the uvula with speech; absence of the gag reflex; vocal chord spasms; or, possibly, a transient aphasia.

Diagnostic measures that may be indicated include: physical and neurological examinations; sensory and motor tests; blood studies; spinal tap; electrocardiogram (EKG); and electromyography (EMG).

Treatment may depend on the underlying cause. Measures of treatment may include: medications for pain; botox for vocal chord spasms; peripheral nerve blocks if pain medications fail; or physical therapy for certain types of neuralgia. Surgical resection may be necessary when medical therapy fails.

Frequency of attacks may vary with periods of long remissions. However, remission periods may decrease with age. Continuous bouts may be incapacitating and may alter activities of daily living (ADL). The nutritional status may decline, and there may be a temporary need for tube feedings. There may also be a need for long-term pain management. Medications may warrant ongoing liver and blood studies. The potential for paralysis of the nerve exists.

• This disease shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a). [chronic disease].

Notes

• None.