Abstract
We present a 40-year-old woman with Jacobson's neuralgia (otic type glossopharyngeal neuralgia) . The pain had been controlled for a while using oral ketamine and topical dibucaine instillation for the tympanic membrane. However, the otalgia worsened after we abandoned prescribing oral ketamine, so she went to another hospital seeking other therapeutic possibilities including surgery. Sixteen months later, she suffered from multiple gastric ulcers due to the anticonvulsant, antidepressant, muscle relaxant, migraine drug, and nonsteroidal anti-inflammatory drugs. Her activities of daily living were disturbed by dizziness and drowsiness caused by the medication. She decided not to seek further pain relief and stopped taking the above drugs. Now she is in a comparative remission status with occasional 50 mg gabapentin, topical mepivacaine instillation, and physical therapy.
Jacobson's neuralgia is difficult not only to diagnose but also to treat. Patients require support both physically and mentally.
