Glossopharyngeal neuralgia, asystole, and seizures occurred in a patient with an internal carotid occlusion and external carotid stenosis. Swallowing was the triggering mechanism for these events. Mechanical stimulation of the pharynx failed to reproduce the symptoms. An ischemic injury to the glossopharyngeal nerve in the region of the jugular foramen that resulted in an artificial synapse is the proposed etiology.