An elderly woman who presented with Adams-Stokes attacks that were preceded by paroxysms of neuralgia was successfully treated with carbamazepine. Ventricular asystole was provoked by pharyngeal pain and coincided with loss of consciousness. Vagal reflexes are probably responsible for the bradycardia that causes the cardiac symptoms of glossopharyngeal neuralgia. Carbamazepine (600 mg/day) abolished the pharyngeal pain and associated cardiovascular manifestations in this patient for at least ten months.
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