Neuralgia - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Nerve Disease

  • Causes and Diagnosis neuralgia
  • Trigeminal neuralgia
  • Neuralgia pterygopalatine node
  • neuralgia glossopharyngeal nerve
  • Herpetic Neuralgia
  • intercostal neuralgia
  • Neuralgia femoral nerve
  • Treatment of neuralgia

Neuralgia - itperipheral nerve damage, is an acute, severe, burning, piercing pain in the area of ​​innervation of the affected nerve.

If neuropathy (neuritis) is characterized by symptoms of loss of nerve function, for neuralgia is characterized by symptoms of irritation.Distinguish cranial neuralgia (trigeminal, glossopharyngeal) and spinal (intercostal) nerve and femoral nerves neuralgia Causes

hypothermia, inflammatory diseases, trauma, tumors, poisoning, stress, demyelinating processes can cause neuralgia.

Diagnosis neuralgia

differential diagnosis of a neurologist involved.Diagnosis of neuralgia begins with a neurological examination of the patient with the typical complaints for this disease.These causes of neuralgia require a full examination to identify or eliminat

e the underlying disease.

In some cases, may require additional instrumental examination (electroneurogram) if the cause of the neuralgia had an injury in the projection of the nerve.It may require an MRI of the spine or of any of the nerve plexus in the event of any surround effects on neural structures, as is the case with the protrusion or herniation of intervertebral disk or soft tissue tumor.

Trigeminal neuralgia

Or, as they call the patients - "neuralgia of the facial nerve."Trigeminal nerve - a V pair of cranial nerves that provides sensitive and partly motor innervation of the face and mouth.The orbital and maxillary nerve branch - purely sensitive, in the third - the mandibular branch has motor fibers that innervate the muscles of chewing.Trigeminal nerve - the main nerve that provides the sensitivity of the face - the surface - tactile and painful, deep - proprioceptive.Powerful sensitive innervation provide Gasser's ganglion (trigeminal ganglion), the nerve connection with the thalamus - the sensitivity center of the medial loop, the spinal cord.


Trigeminal neuralgia is the so-called central and peripheral due to causal factors.

  • Central genesis - is a painful paroxysm of cortico-subcortical origin - hypothalamic paroxysms, epileptic, dysphoria. Paroxysm - is a manifestation of the disease, which occurs suddenly, is dramatically different, contrasting with respect to normal, it lasts for a short time - a few seconds or minutes, abruptly terminated spontaneously.Trigeminal neuralgia can be treated as the equivalent of epilepsy - as this paroxysm, short-term, during which there are spikes on the EEG slow wave activity, and has the effect of anticonvulsant therapy.
  • Peripheral genesis - primary neuralgia - a painful syndrome that occurs primarily in infections, viral (herpes) and toxic lesions, toxic-allergic and sosudistyh- irritation, compression of the trigeminal nerve vessels - aneurysm, malformation, pathologically tortuous blood vessels ...Secondary neuralgia - is pain in diseases of ENT organs, teeth, upper cervical spine, multiple sclerosis, bass, trauma, tumors, cerebrospinal transition.

Symptoms of trigeminal neuralgia:

is pain - short-term, may be different in nature, but it is always very strong "incompatible with life", a one-way, local - in the zone of innervation of the affected nerve branch.

pain of trigeminal neuralgia

pain is accompanied by vegetative reactions - lachrymation, hypersalivation (uncontrolled salivation), erythema (redness).Pain can be provoked by touching the points Kurkov, chewing, talking, shaving.With the defeat of the mandibular branch of the trigeminal nerve are possible movement disorders in masticatory muscle - twitching, spasms, atrophy.

flow idiopathic neuralgia long - years, with periods of remissions and exacerbations.Duration of remission and exacerbation frequency individual, associated with provoking moments.Possible persistent and prolonged remission.Current secondary neuralgia depends on the underlying disease.

Neuralgia pterygopalatine node

pterygopalatine node - the parasympathetic nervous education that combines II branch of the trigeminal nerve, the parasympathetic part of the facial nerve, the sympathetic plexus of the internal carotid artery and having a connection (anastomosis) verhnesheynymi sympathetic nodes.


Neuralgia pterygopalatine node (neuralgia Sludera) usually occurs in inflammatory processes in the ENT organs.


unilateral pain sharp, penetrating in the eye sockets, nose root of the upper jaw, teeth, pain, increasing the possible irradiation in the head, tongue and neck.The pain is accompanied by severe unilateral autonomic disorders - eye redness, lacrimation, salivation, blepharospasm, edema.Paroxysm of Pain usually occurs at night and may be from minutes to hours and days.The disease lasts a long time with periods of exacerbation and remission.Fatigue, cold, strong emotions, alcohol can provoke an aggravation of the disease.

neuralgia glossopharyngeal nerve glossopharyngeal nerve

- IX pair of cranial nerves, which provides the sensitivity of the tonsils, the soft palate, the tympanic cavity, taste sensitivity of the back third of the tongue, parotid gland secretory function, motor innervation of muscles of the pharynx.


Distinguish primary neuralgia - idiopathic and secondary - symptomatic - in infectious diseases (angina, tonsillitis, flu), injuries bed tonsils, tumors of the cerebellopontine angle tumors of the larynx, fracture of the skull base, as a complication of operations tonsillectomy, tracheotomyIVL.


neuralgia glossopharyngeal nerve - it's a pain, paroxysmal, unilateral in the language of the tongue, throat, soft palate, in the ear.The pain is caused by eating, swallowing, yawning, coughing, taking much hot or cold food.The pain is accompanied by autonomic reaction - hypersalivation or dry throat may change in taste - everything seems bitter or taste may be lost.The attack can be provoked by swallowing, talking.

Herpetic Neuralgia


Herpetic Neuralgia - the most common complication of herpes infections, especially in the elderly and in patients with impaired immunity.Herpetic neuralgia occurs in lesions of the ganglia and development and how ganglionitis postherpetic neuralgia.


At the heart of the pain of postherpetic neuralgia are inflammatory changes in dorsal root ganglia of the spinal cord and peripheral nerves in the affected areas.Severe pain can hold up to 6 months.Various pain - constant, deep, dull, pressing or burning pain;spontaneous, intermittent, stabbing, shooting, similar to the "shock";pain during dressing or light touch.

Intercostal neuralgia


Intercostal neuralgia - acute pain along the intercostal nerve, aggravated by movement, the body turns on inspiration.It is not possible, because of the severe pain, breathe deeply - a man restrains the breath, afraid and breathe and move.On palpation determined by a sharp pain along the intercostal space.Coughing and sneezing cause severe pain.


Call intercostal neuralgia may be hypothermia, severe stress, a sudden movement, a long uncomfortable posture, physical load, inflammatory diseases, coughing, ribs injury, the pathology of the thoracic spine.

When intercostal neuralgia necessarily examination of the chest to detect / exclude pneumonia, pleurisy, pneumothorax.When left-sided localization of pain - is necessarily necessary examination of the heart - the electrocardiogram to rule out heart disease - angina pectoris, myocardial infarction .You will also need a complete blood count, possibly thoracic radiography.

Neuralgia external femoral cutaneous nerve


Neuralgia external femoral cutaneous nerve (Roth's disease) - a pain, burning, paresthesia (tingling, crawling sensation on the skin), numbness in the area of ​​innervation of a nerve - anterior-outer thigh.The pain can be paroxysmal and persistent, sharp and aching, long.

Neuralgia femoral nerve


It may be neuralgia of the femoral nerve in metabolic disgemicheskih disorders - diabetes, alcohol intoxication, vascular diseases of the lower limbs, with compression of the nerve at the exit site below the inguinal fold - bandages, whilepregnancy, in case of injuries.


neuralgia neuralgia treatment appoint a neurologist.

are used anticonvulsant drugs - Gabapentin - gabantin, Tebantin, gabagamma;finlepsin, carbamazepine;B vitamins - kokarnit, milgamma, Neurovitan, neyrorubin;muscle relaxants - Mydocalmum, sirdalud, baclofen;topical creams and gels - Deep Relief, Apizartron, Fastum gel ... individually - physiotherapy, acupuncture, spa treatment.

Studies have shown that taking vitamin B complex B1, B6 and B12 has a positive effect on the nervous tissue in diseases such as the optic neuritis, sciatica, and various types of neuralgia.To restore the analgesic effect and nerve structures recommended Neyromultivit - a medicament containing a combination of vitamin B1 (100mg), B6 ​​(200mg) and B12 (200mkg) in dosages that are higher than in standard multivitamin preparations.The use of complex tools effectively use analgesics: the drug is not only removes unpleasant symptoms, but also eliminates the cause of the pain.The drug is available in tablet form, which is especially convenient for use at home and at work, and economical package of 60 tablets is enough for a full course of treatment.

If neuralgia is secondary - treatment of the underlying disease in the appropriate specialist.Such neuralgia tested after the treatment of the underlying disease or the achievement of its remission.Current neuralgia is dependent upon the underlying disease.

In the absence of contraindications to physiotherapy may be used:

- in acute period of trigeminal neuralgia exposure lamp sollux, UFO, infrared rays slaboteplovaya dosage - the patient side of the face, CMT or DDT innervation zone or half-mask on the face, cervical spinespine, electrophoresis with novocaine, salicylates, vitamin B1 may intranozalnaya and technique introduction, ultrasound with hydrocortisone on trigger points, electric, laser therapy, acupuncture;
- in remission period used neck massage and facial, ultrasound, mud and paraffin applications on the collar area and half of the face, hydrogen sulfide and sea baths, acupuncture.

When frequent exacerbations and long trigeminal neuralgia , in the case of precisely established reasons (magnetic resonance imaging) - compression of the trigeminal nerve vessel - surgical treatment - microvascular decompression.Held division nerve and compressing its vessels.Operation - open craniotomy .Anesthesia - general.Complications - facial numbness, double vision, hearing loss, complications related to anesthesia, infections ...

chemical and electrical destruction of the nerve is now almost never used.

When pharmacoresistance during neuralgia, after failure of surgical treatment, if desired, the patient used stereotactic radiosurgery using the installation - « Gamma Knife », for example, when neuroma trigeminal nerve compression of the arteriovenous malformation - a progressive method of treatment does not require anesthesia, hospitalization(duration of the intervention from minutes to hours) and completely cures the patient (may decrease the sensitivity in the area of ​​innervation of the trigeminal nerve).

When neuralgia glossopharyngeal nerve use the CMT to the area of ​​the cervical sympathetic ganglia, ultrasonic analgin, novocaine eufillina paravertebrally, UHF on collar region, laser puncture, acupuncture, massage of cervical area.For acute pain apply lubrication dikainom tongue.

When intercostal neuralgia used UFO segmental zones, electrophoresis of novocaine, lidocaine on pain intercostal spaces zone darsonvalization.Outside exacerbation - Paraffin, mud and ozocerite baths, radon and hydrogen sulfide baths, massage.

When neuralgia femoral nerve using DDT, CMT paravertebrally innervation zone and the outer thigh cutaneous nerve, salicylates electrophoresis, Novocaine, darsonvalization, magnetic therapy, massage lumbar spine and legs, acupuncture.In remission - spa treatment with a full arsenal of rehabilitation.

Physiotherapy relieve pain with muscle relaxant, anti-inflammatory, sedative effect, improves blood circulation and trophism, stimulate acupressure points, transported drugs.

neuralgia associated with degenerative-dystrophic processes in the spine is a therapeutic exercise, swimming, water aerobics, training on simulators.

Prevention neuralgia

As a preventive measure makes sense to avoid exposure to cold, drafts, injuries.Encouraged a healthy lifestyle, chronic disease, taking B vitamins, physiotherapy.

neurologist Kobzev SV