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Question
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A 50-year-old man experiences frequent recurrent pain on the left side of his throat, near his tonsils. He says that this feels like a hot poker. Assuming a radiographic evaluation is unrevealing, which of thefollowing is the appropriate first-line therapy?
Explanation
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Carbamazepine is the first-line therapy for glossopharyngeal neuralgia (as in this case), as well asfor trigeminal neuralgia. Phenytoin and amitriptyline may also be tried, but as salvage options. Levetiracetam is not generally considered in the treatment algorithm for this disorder. Oxycodone may provide temporary benefit, but will not control the disorder overall, and so is only used for emergency or last-resort scenarios.
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Reference
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( Bradleys NiCP, 7th edn, Ch. 103, pp. 12541260)
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Option 1
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Is Correct (Option 1):
Carbamazepine
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Option 2
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Is Correct (Option 2):
Amitriptyline
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Option 3
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Is Correct (Option 3):
Levetiracetam
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Option 4
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Is Correct (Option 4):
Phenytoin
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