A family incorporating 2 interesting variants of trigeminal and glossopharyngeal neuralgia is presented. The familial occurrence of these cranial neuralgias spanning 3 generations is very unusual. In the case of glossopharyngeal neuralgia it has not been documented previously. Furthermore, the coincidence of trigeminal and glossopharyngeal neuralgia in the same person is quite exceptional, despite the anatomical contiguity of the sensory territories of the fifth and ninth cranial nerves. These features suggest firstly that there must be an important constitutional factor in the aetiology of the cranial neuralgia, and secondly that in many cases there is a centronuclear rather than cranial nerve ganglionic pathogenesis of the pain.