Revisão dos conceitos vigentes sobre a clínica, patogenia, diagnóstico diferencial e tratamento da neuralgia vagoglossofaríngea, e relato de três casos operados por neurotomia intracraniana do n. IX e n. X (parcial). A anatomia da inervação sensitiva das regiões profundas da face e transição cervicofacial, com suas implicações clínicas, e a teoria da compressão neurovascular na patogenia das disfunções ditas «hiperativas» dos nervos cranianos, são comentadas criticamente.

Review of current opinions concerning clinical presentation, etiology, differential diagnosis and management of vagoglossopharyngeal neuralgia. Three cases are reported, treated by intracranial section of n. IX (alone in one case) and upper rootlets of n. X. In two patients no vascular compression of the nerves was observed. In one case an atheromatous elongated basilar artery was observed compressing and deforming the medulla oblonga at the entry zone of nerves IX-X. In this case, pain paroxysms recurred, some weeks after surgery, and the patient underwent re-operation (microvascular decompression of the medulla) with good outcome. Clinical implications of the complex sensitive innervation of profound regions of the face and cervicofacial region are emphasized. Certain circumstances, such as gustatory pain due to sympathetic denervation of parotid gland, the neck-tongue syndrome and oropharyngeal pain by irritation of the first cervical spinal nerve (during lateral suboccipital puncture), point to the fact that in this region similar symptoms may be provoked by mechanisms involving different peripheric pain pathways. The theory of microvascular compression in the pathogeny of cranial nerve «hyperactive» dysfunctions is critically commented.