A Case of Cala Trio-Induced Glossopharyngeal Neuralgia in a Patient with Essential Tremor and Idiopathic Parkinson’s Disease

Background: Cala Trio is a wrist-worn transcutaneous afferent patterned stimulation (TAPS) device for essential tremor (ET), delivering high-frequency stimulation to the median and radial nerves. Case Report: We report the first case of glossopharyngeal neuralgia (GPN) associated with Cala Trio initiation in a 69-year-old male with ET and Parkinson's disease, with prior GPN. Throat spasms triggered by swallowing and coughing began after initiation on two trials and resolved with discontinuation; evaluation was unrevealing. Discussion: We review TAPS mechanisms, GPN neuroanatomy, and circuit-level links between peripheral nerve stimulation and brainstem cranial nerve hyperexcitability, highlighting a novel adverse event and need for caution in patients with prior GPN. Highlights: We report the first case of glossopharyngeal neuralgia associated with Cala Trio TAPS therapy in a patient with essential tremor and Parkinson's disease. Symptoms were temporally linked to device use and resolved upon discontinuation, suggesting a reversible neuromodulation-related effect and expanding the safety profile of peripheral tremor therapies.