Glossopharyngeal neuralgia is an uncommon disorder in which pain similar in quality to that in trigeminal neuralgia occurs in the throat, about the tonsillar fossa, and sometimes deep in the ear and at the back of the tongue. The pain may be precipitated by swallowing, chewing, talking, or yawning and is sometimes accompanied by syncope. In most instances, no underlying structural abnormality is present; multiple sclerosis is sometimes responsible. Oxcarbazepine and carbamazepine (see Table 24–3) are the treatments of choice and should be tried before any surgical procedures are considered. Microvascular decompression is generally preferred over destructive surgical procedures such as partial rhizotomy in medically refractory cases and is often effective without causing severe complications.