A Case of Isolated Unilateral Glossopharyngeal Nerve Palsy

Abstract

Isolated palsy of the glossopharyngeal nerve is rare. We report the case of an elderly patient with unilateral right glossopharyngeal nerve palsy secondary to extra cranial ischemia. On examination there was no other deficit other than an absent right gag reflex. We diagnosed her with ischemic stroke of the ninth nerve clinically and increased her daily dose of Aspirin from 81 mg to 325 mg. The magnetic resonance imaging of the brain showed a normal brainstem and cerebellum with patent intracranial circulation. Total resolution of the paralysis was seen two months later. The possible mechanisms suspected are diabetic or hypertensive stenosis of the vasa nervorum or compression of the ninth nerve by an internal carotid artery dissection or aneurysm. This article discusses the various etiologies and mechanisms of this rare condition. It is unique because of the nerve’s location and relation to other structures.