Neuralgia of the trigeminal nerve – symptoms, causes, treatment. In what neighborhoods does it attack?

Proven content

Trigeminal neuralgia is a condition characterized by brief and sudden bouts of pain that usually affects the largest cranial nerve and presents with bouts of pain in the half of the face. Neuralgia can occur once, but it can also recur and make life unpleasant even several times a day. They are usually treated with pharmacological agents.

Trigeminal neuralgia – definition

Neuralgia is a condition characterized by sudden and brief attacks of pain that usually affect the face. The pain appears suddenly and subsides just as quickly, and the patient feels as if he has been pierced by electricity. Neuralgia occurs spontaneously and unprovoked, but can also be the result of touching the face or brushing the teeth – when one of the three branches of the trigeminal nerve is irritated on the face near the brow bone, eye and jaw.

What areas is affected by the neuralgia of the trigeminal nerve?

The location of neuralgia depends on the innervation area of ​​the trigeminal nerve. The trigeminal nerve is responsible for facial sensation and gives off three branches:

1. nerw szczękowy — unerwiona jest skóra poniżej szpary powiek oraz powyżej szpary ust;
2. optic nerve – the scalp above the eyelid fissure and the side of the nose are innervated;
3. mandibular nerve – the skin below the mouth and temples is innervated.

Forms of trigeminal neuralgia

Neuralgia can actually attack each nerve branch separately (e.g. only the optic nerve – then we feel pain in the forehead area) or all three of its branches – then the neuralgia affects half of the face. Neuralgia of the trigeminal nerve occurs in two forms:

1. classical trigeminal neuralgia – otherwise known as spontaneous neuralgia of unknown etiology. It is the most common form of neuralgia, more often than symptomatic, and mainly affects people over 40;
2. objawowa neuralgia nerwu trójdzielnego — pojawia się w przebiegu innych dolegliwości i dotyczy tylko 2% przypadków. Przyczyną może być ucisk korzenia lub zwoje nerwów przez występujący nowotwór (guz) bądź naczynie krwionośne.

Important! Patients who develop trigeminal neuralgia before the age of XNUMX should be referred to a specialist for the cause of the disease. There is a chance that the patient has a symptomatic form of the disease.

Symptoms of trigeminal neuralgia

The pain that occurs in trigeminal neuralgia can be very intense, but at the same time brief. It is most often associated with the second and third branches of the trigeminal nerve, then the nerve is located in the middle and lower area of ​​the face (from the eye to the chin). It is less common to encounter neuralgia of the optic nerve.

Neuralgia of the trigeminal nerve:

1. usually lasts several seconds (does not exceed two minutes);
2. does not exceed the midline of the body;
3. it appears periodically, then the phases of remissions and relapses appear regularly;
4. it usually appears several times a day, usually during the day (less often at night);
5. it may be continuous, especially in some patients when pain attacks occur one after the other (neuralgic state);
6. in most patients it attacks unilaterally (it occurs bilaterally, e.g. in patients with multiple sclerosis).

Neuralgia of the trigeminal nerve is also characterized by the so-called trigger areas, i.e. those whose touching leads to an attack of pain. Such zones are usually present on the cheek and around the patient’s mouth, so even the simplest daily activities can cause pain, such as brushing your teeth or experiencing emotions. In addition, in patients with neuralgia of the trigeminal nerve, facial grimaces resembling nervous tics can be observed.

Neuralgia of the trigeminal nerve – causes

Trigeminal neuralgia may appear as the so-called spontaneous neuralgia or as a consequence of inflammation, compression or damage to a nerve that sends stimuli to the brain instead of transmitting them. Neuralgia of the trigeminal nerve often occurs periodically – they attack regularly for several weeks, then calm down for several months and attack again. The most common time of year for trigeminal neuralgia is winter. However, in a certain group of patients, pain of varying intensity occurs continuously throughout the year.

Neuralgia of the trigeminal nerve – diagnosis

Diagnostyka nerwobólu nerwu trójdzielnego opiera się w głównej mierze na przeprowadzeniu wywiadu lekarskiego z pacjentem. Ważne jest również wyeliminowanie objawowej postaci choroby. W tym celu lekarz zleca badania dodatkowe w postaci rezonansu magnetycznego, angiografii oraz badania somatosensorycznego potencjałów wywoławczych.

The diagnosis of classic trigeminal neuralgia takes into account whether the patient has facial pains lasting from a few seconds to 2 minutes, and whether they involve the area of ​​at least one branch of the trigeminal nerve. In addition, it should meet the following criteria:

1. there is intense pain that may be superficial or stinging;
2. pain appears as a result of irritation of the trigger spheres;
3. there are no other neurological deficiency symptoms;
4. other causes of pain were excluded;
5. the attack of pain is characteristic, similar to each patient.

What should be excluded in the differential diagnosis to distinguish classical from symptomatic neuralgia?

1. Stwardnienie rozsiane.

2. Aneurysm of the primary artery.

3. Viscosity of the pad.

4. He called the brain stem.

5. Vascular-nerve conflict.

6. Compression of the trigeminal nerve from other causes.

7. Tumor of the cerebellopontine angle.

Trigeminal neuralgia – treatment

Trigeminal neuralgia is treated with drugs or surgery. Pharmacotherapy is used at the beginning, then patients are given a preparation of carbamazepine or tricyclic antidepressants. In some cases, it may be poorly tolerated (dizziness and headache), therefore blood carbamazepine concentration should be tested. If this is ineffective, other preparations are recommended, including valproic acid, phenytoin, baclofen or clonazepam. If the therapy does not significantly attenuate the attacks, acupuncture is recommended or surgery is performed. The surgeon’s intervention may include:

1. exclusion of a given area of ​​the face from feeling;
2. damage to the trigeminal nerve in a targeted manner so that it does not conduct pain;
3. damage to the roots of the trigeminal nerve (with the help of glycerol).

As an adjunct in the treatment of neuralgia, you can use relaxing green tea with verbena and lemon balm in its composition. You can now buy it on Medonet Market at a favorable price. Mint is also beneficial for neuralgia, e.g. it is available in the form of freeze-dried organic tea. If you suffer from neuralgia, you can also try the prophylactic and healing chamomile flower.

To soothe pain and improve your well-being, it is also worth using the therapeutic power of heat. Buy the VITAMMY Heat Electric Heating Cushion and the Vitammy Thermo 1x Electric Blanket, which you can find at Medonet Market, at a promotional price now.