Glossopharyngeal neuralgia, also known as glossopharyngeal neuralgic convulsions, is a rare clinical condition that refers to recurrent episodes of searing or stabbing pain confined to the area innervated by the sensory branches of the glossopharyngeal nerve, sometimes accompanied by the distribution of the auricular and pharyngeal branches of the vagus nerve. It is characterized by severe paroxysmal pain in the tonsils, posterior pharynx, posterior tongue, and middle ear. It can be spontaneous, but often comes on suddenly from swallowing, talking, or touching the posterior tonsillar pharynx. The former is of unknown etiology and may be the result of demyelinating changes in the linguopharynx and vagus nerve, causing a short circuit between the afferent impulses of the linguopharyngeal nerve and the vagus nerve, with no apparent relationship to infection of the teeth, larynx and paranasal sinuses. Glossopharyngeal neuralgia is a sudden onset of severe pain in the posterior 1/3 of the tongue and tonsils on one side, and rapidly radiates to the pharynx, larynx, soft palate, Eustachian tube, external auditory canal, middle ear, and the anterior and posterior regions of the external ear. 1. Triggering factors Pain often occurs due to swallowing, talking, yawning or ear-pulling, and can be triggered by other head and neck activities. In severe cases, the patient refuses to eat or even dares not swallow saliva in order to reduce the attack, but adopts a low posture to let saliva flow out from the mouth on its own. During the examination of the patient, if the distribution area of the linguopharyngeal nerve is touched, severe pain can be induced. The pain is mostly limited to the posterior wall of the pharynx, the root of the tongue, the tonsil area and the external auditory canal. Although it varies from patient to patient, it does not exceed the above-mentioned range. The pain is similar to trigeminal neuralgia, with episodes of stabbing, cutting or burning pain, lasting from a few seconds to several minutes. Some patients have milder pain. 4. “Trigger points” are mostly in the tonsils, soft palate, posterior pharyngeal wall or external ear canal, etc., and can cause painful attacks when touched. The “trigger point” can be relieved by cocaine anesthesia. 5.Other symptoms Individual patients may have bradycardia, cardiac arrest, blood pressure drop, syncope and convulsions during pain attack. The bradycardia or cardiac arrest is caused by overexcitation of the sinus nerve (a branch of the glossopharyngeal nerve) innervating the carotid sinus, which leads to excessive hyperfunction of the vagus nerve, and some authors speculate that it may be related to the hypersensitivity of the vagus nerve itself and the formation of pseudotactic synapses at the proximal end of the glossopharyngeal nerve. The syncope and convulsions were caused by bradycardia, cardiac arrest, which led to a drop in blood pressure and severe cerebral ischemia and hypoxia.