Help the development of the site, sharing the article with friends!

Neuralgia (neuralgia) of the trigeminal nerve, or facial pain, is an attack of acute pain limited to the area of ​​the forehead, cheek, nose or jaw. It only lasts several dozen seconds, but is extremely strong. What are the causes of trigeminal neuralgia? How is the treatment of trigeminal neuralgia?

Neuralgia( neuralgia )of the trigeminal nerve( facial pain , Latinneuralgia nervi trigemini , Trigeminal Neuralgia) happens regardless of gender and age, although most statistics show that the victims of this disease are usually women over 50. years of age.

The attack is caused by stimuli that are completely harmless in normal conditions, e.g. cold, lip movement, a gust of wind or biting a hard bite of food. Over the years, the intensity of the symptoms may increase.

Trigeminal neuralgia attacks areas of the face innervated by its three main branches (separate on either side of the head) that conduct touch, cold, heat and pain. This is why the trigeminal nerve is composed primarily of sensory fibers - innervating the cheeks, temples, forehead, nose and chin - although the lowest branch also contains motor fibers for the muscles that move the mandible.

It is worth adding that the trigeminal nerve is one of the twelve cranial nerves which, unlike the spinal nerves, depart symmetrically from the brain and leave the skull through the holes in its base.

It is also the thickest nerve, the branches of which - eye, maxillary and mandibular - divide like tree branches into smaller and smaller branches as they move away from the main trunk.

Thanks to this, the face is one of the most innervated areas of the whole body, which unfortunately also exposes it to pain sensations.

Neuralgia of the trigeminal nerve: symptoms

- The pain is unbearable, I walk on the wall, I feel the current in my head - these are the colorful terms used by victims of neuralgia when trying to describe pain attacks. It can be rushing, stinging, burning, shooting, stabbing, excruciating.

- These people even attempt suicide - admits Dr. Janina Pernak de Gast, an anesthesiologist specializing in pain therapy, pointing to the scale of the problem that leavinga patient with an attack of trigeminal neuralgia without proper care.

She is particularly sensitive to this group of patients: - They really suffer. This disease, although its attacks last for a short time, can take away the joy of life. Fortunately, the pain is not permanent.

A characteristic feature of this type of ailments are the series of painful attacks lasting usually several dozen seconds (less often they last up to an hour), which pass and then come back again after some time.

And they can be caused by a gentle gust of wind, a feeling of coldness, and sometimes lip movements - hence many patients, even when nothing hurts them, live in fear of another attack that they can never predict. They try to belay: they talk through clenched teeth, squint their eyes.

Neuralgia of the trigeminal nerve: causes

A common cause of this type of neuralgia is a blood vessel that compresses the trigeminal nerve in the cranial cavity, most often where the nerve enters the brain.

Pulsating pressure of the vessel on delicate nerve fibers after some time destroys their sheath, which interferes with the transmission of sensory stimuli. Something that would not be a problem for he althy people, causes unbearable suffering in people with neuralgia.

The list of causes leading to trigeminal neuralgia, however, is longer than the compression of the pulsating artery, which, due to a whim of nature, runs too close to the ganglion or nerve trunk.

A similar effect can be caused by changes in the skull that indicate a more serious disease, such as a growing brain tumor, bone growth or an aneurysm.

- In many people, the source of neuralgia is an incorrectly extracted tooth, when during extraction damage to one of the nerve branches. It can also be a consequence of shingles or accompany multiple sclerosis, says Dr. Pernak de Gast. - And it happens that neuralgia occurs for no apparent reason. Someone goes for a walk, the wind blows them and returns home with excruciating pain that will accompany him for many years.

Neuralgia of the trigeminal nerve: diagnosis

Choice of therapy Treatment of neuralgia must be preceded by the diagnosis of its cause. Of course, provided that it can be established at all (which is not always possible in the case of this disease).

To exclude any changes in the face, a dental, ophthalmological and ENT examination is recommended.

If neuralgia is suspected, the source of which may be pressure on a blood vessel or a brain tumor, an MRI of the head should be performed, as it will reveal any abnormalitiesinvisible to the naked eye.

- Such accurate diagnostics sometimes takes a lot of time, but we have to be sure that the applied treatment turns out to be appropriate - says Dr. Janina Pernak de Gast.

Neuralgia of the trigeminal nerve: treatment

If the causes of neuralgia can be removed surgically - by excision of the tumor or separation from the nerve of the pulsating cerebral artery - then the patient is referred as soon as possible to a neurosurgeon who will perform the necessary surgery.

Any other cause of neuralgia is an indication for treatment with antiepileptic agents, which have been shown to be effective in relieving this type of ailments. And although many patients who use these drugs complain of lethargy, nausea or dizziness - getting rid of the pain is worth even such troublesome side effects.

But it may be that the administration of tablets does not bring the expected relief. According to our expert, it can be noticed after 3-4 weeks - if the treatment does not help and the bouts of pain continue, it is not worth increasing the doses of anticonvulsants indefinitely.

Then it is better to think about radical surgical removal of the trigeminal nerve or about thermolesion, i.e. precise switching off of nerve fibers under the influence of current with radio frequency waves.

monthly "Zdrowie"

Help the development of the site, sharing the article with friends!

Category:

Neurology