Neuralgia means nerve pain.
Damaged nerve not always regenerates properly. Sometimes it degenerates further and loses its function. When neurons lose their function or begin to malfunction, abnormal signals sent to the brain, may be translated as painful signals. The pain can be brief, painful attacks, sharp, electric shock like pain, which can lasts for several minutes.
If Pain is more constant and continuous, pain along the nerve, it is called atypical form of neuralgia. For example atypical trigeminal neuralgia.
The most common Neuralgias are: trigeminal, postherpetic, and occipital neuralgia.
Neuralgia commonly described as one of the most excruciating pains that can be experienced.
Trigeminal neuralgia, is the most common neuropathic pain.
It is characterized by sudden, brief, usually unilateral severe recurrent episodes of stabbing pain.
Commonly described as paroxysmal, electric shock-like, or burning.
Intense stabbing pain lasts from several seconds to several minutes.
Pain attacks usually occur by stimulation of trigger points within the territory supplied by the trigeminal nerve.
Examples of stimulation include touching the face, tooth brushing, talking, feeding and cold air.
After pain episode, refractory episode comes. Which lasts up to several minutes. Then pain attack again.
Such pain attacks impairs person’s quality of life. She may avoid talking and daily activities.
the majority of cases of trigeminal are referred to as idiopathic, because of unknown cause.
Although many are associated with vascular compression of the trigeminal nerve, close to its exit from the brainstem, by an aberrant loop of an artery or vein. A minority of cases are due to conditions like multiple sclerosis or nerve compression by a tumor.
Trigeminal neuralgia is more common among females and commonly occurs after 50 years of age.
It is very rare among children and young people. And usually right side of face is involved.
Diagnosis is made by symptoms.
Treatment:
Carbamazepine or oxcarbazepine should be offered as first line treatment.
The usual doses of carbamazepine (200 to 1200 mg per day).
Other drugs used:
Baclofen, lamotrigine, clonazepam, topiramate, phenytoin, gabapentin, pregabalin, and sodium valproate can be used.
Most patients respond well to drugs. If drug treatment fails or is not tolerated, surgical treatments may be offered. Microvascular decompression has been widely accepted as the gold standard surgical procedure for treating this disease.
Antidepressants such as duloxetine, can also be used for treatment of neuralgia.
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