Neuralgia refers to severe shooting pain that occurs due to a damaged or irritated nerve. Neuralgia can affect any part of the body, causing mild to severe pain. Certain medications and surgical procedures can effectively treat neuralgia.
Severe neuralgia can affect a person's ability to perform everyday tasks and can affect their quality of life.
Neuralgia has many possible causes, including:
- infections such as shingles, Lyme disease, or HIV
- pressure on bone nerves, blood vessels or tumors
- other medical conditions such as kidney disease or diabetes
- aging
This article examines the different types of neuralgia, their symptoms, and available treatment options.
Types of neuralgia
Medical professionals divide neuralgia into categories based on the areas of the body that it affects. The following are some common types of neuralgia :
Trigeminal neuralgia
TN can cause shooting pain in the face.
Trigeminal neuralgia (TN) involves the trigeminal nerve in the head. It has three branches that send signals from the brain to the face, mouth, teeth and nose.
TN is divided into two divisions: type 1 and type 2.
Type 1 TN causes a painful burning or electric shock sensation in some parts of the face. People with type 1 TN experience irregular episodes that come on suddenly.
The duration of these episodes varies among individuals, but can last up to 2 minutes, according to the National Institute of Neurological Disorders and Stroke.
Type 2 TN produces a constant, dull, aching sensation on the face.
The exact cause of TN remains unclear. However, pressure from the enlarged blood vessel can irritate or even damage the trigeminal nerve.
Multiple sclerosis (MS) can lead to TN. MS is a neurological disorder that causes inflammation that damages the myelin sheath surrounding nerve fibers in the central nervous system.
Postherpetic neuralgia
Postherpetic neuralgia (PHN) is a painful condition that affects the nerves of the skin.
According to the Centers for Disease Control and Prevention (CDC), PHN is the most common complication of shingles, affecting about 10–13% of people who develop it.
Shingles is a viral infection that causes blisters and a painful skin rash. The varicella zoster virus, which causes chickenpox, remains dormant in the nervous system and becomes active later in life, causing shingles.
When the virus is reactivated, it can cause inflammation of nerve fibers. This inflammation can lead to permanent nerve damage, which causes pain even after the infection subsides.
Occipital neuralgia
This form of neuralgia affects the occipital nerves, which originate in the neck and send signals to the back of the head.
Occipital neuralgia causes throbbing or shooting pain that begins at the base of the skull and spreads along the scalp. Pain in occipital neuralgia may flow to the back of the eyes.
Occipital neuralgia has many potential causes, including:
- sudden head movements
- tense neck muscles
- lesions or tumors in the neck
- inflamed blood vessels
- infections
- gout
- diabetes
- neck injuries
Peripheral neuralgia
Peripheral neuralgia, or peripheral neuropathy, refers to pain that occurs due to nerve damage in the peripheral nervous system. This includes all nerve fibers outside the brain and spinal cord.
Peripheral neuralgia can affect one nerve or entire nerve groups.
Sustained damage to the peripheral nervous system can affect the nerves that control muscle movement, transmit sensory information, and regulate internal organs.
Peripheral neuralgia can cause pain or numbness in the arms, legs, arms and legs. Other symptoms may include:
- involuntary muscle twitching or spasms
- loss of coordination
- difficulty performing complex motor tasks such as buttoning a shirt or tying shoelaces
- hypersensitivity to touch or temperature
- excessive sweating
- gastrointestinal problems
- difficulty eating or swallowing
- it's hard to talk
Intercostal neuralgia
Intercostal neuralgia affects the nerves that sit just below the ribs. Doctors call the muscles in this area the intercostal muscles.
Several potential factors may contribute to intercostal neuralgia, such as:
- injuries or surgical procedures involving the chest
- pressure on the nerves
- shingles or other viral infections
Intercostal neuralgia causes sharp, burning pain that affects the chest wall, upper abdomen, and upper back. Certain physical movements, such as breathing, coughing, or laughing, can make the pain worse.
Additional symptoms may include:
- tightness or pressure that envelops the chest
- tingling or numbness in the upper chest or upper back
- muscle twitching
- loss of appetite
Diabetic neuropathy
Diabetic neuropathy is the most common complication of diabetes. Because diabetes affects so many people, rates of peripheral neuropathy are now starting to rise.
Symptoms include loss of balance and numbness, tingling and pain. The best way to prevent diabetic neuropathy is to keep your blood sugar levels within an acceptable range.
How to treat intercostal neuralgia?
Since this symptom develops against the background of a large number of different diseases, the doctor must accurately identify the cause of its occurrence and prescribe adequate treatment.
Intercostal neuralgia sometimes simulates an attack of heart pain, but discomfort appears predominantly in the left half of the chest; moreover, it does not depend on breathing or movement and does not occur with external palpation.
The most advanced diagnostics are now possible using the most modern research methods, such as computed tomography and magnetic resonance imaging. These techniques make it possible to detect neoplasms, signs of changes in the brain and spinal cord, and damage to internal organs with high accuracy.
During the acute period, the patient should strictly observe a rest regime. It is necessary to limit sudden movements, physical activity, and body turns. Sitting should be avoided. You need to lie on a flat and level surface. You can apply sand in bags, pepper patch, or a heating pad, that is, dry heat, to the painful area. To enhance the thermal effect, you can tie yourself with a scarf made of natural wool.
Treatment of neuralgia
Treatment options for neuralgia vary depending on the type and severity of the condition.
Ointments, local nerve blocks, and steroid injections may provide temporary pain relief for mild neuralgia.
Treatment for severe neuralgia pain may require prescription drugs, surgical procedures, or both.
Medications
Painkillers are generally not very effective in controlling neuralgia pain. Medications that can treat the underlying causes of neuralgia include :
- anticonvulsants such as carbamazepine, topiramate, and lamotrigine
- antidepressants such as amitriptyline
- muscle relaxants such as baclofen
- membrane stabilizing drugs such as gabapentin
Approaches to taking anticonvulsants
If previously the main goal of treating epilepsy and taking anticonvulsants was to prevent new seizures, today an integrated approach takes first place, taking into account the patient’s quality of life and maintaining his ability to work during treatment
Finding effective therapy can be difficult. This is influenced by factors such as compliance with medication regimen and side effects. Changing drugs by trade name, but with the same active ingredient, can also lead to worsening problems.
Typically, one drug is used at the beginning of treatment for epilepsy, but the dosage and medication may vary. If the desired result is not achieved, only then connect a second remedy and use various combinations.
Finding effective therapy can sometimes be difficult.
Anticonvulsants
There are 3 main mechanisms used to treat epilepsy:
- Stabilization of the membrane potential of nerve cells due to the influence on ion channels. Due to this, K+ ions remain in the cell, and Na+ ions outside. The effect can also be exerted through Ca2+ channels. This maintains “rest” on the membrane of nerve cells.
- Suppression of processes involved in excitation.
- Strengthening braking mechanisms.
Many drugs act on several mechanisms at once and it will not be possible to divide them into groups on this basis.
Medicines:
Depakine Chronosphere , Convulex , Encorat chrono . Valproic acid preparations. They have a muscle relaxant effect and enhance inhibitory processes in the brain. Absorption of the drug may slow down when taken with food. Side effects include : weight gain, hair loss, gastrointestinal problems, tremors.
Finlepsin retard , Tegretol CR , Carbatol. They belong to carbamazepine drugs and are used for grand mal seizures and mixed forms of epilepsy. Contraindications: absence and myoclonic seizures. Side effects: dizziness, drowsiness, headache, but stopping treatment often causes a skin rash.
Phenobarbital , Benzonal , Maysolin . They belong to the group of barbiturates. Can be used for any type of epilepsy attack. Often used in infants. There is a marked slowdown in mental processes. Children have the opposite reaction and develop hyperreactivity. They reduce motor activity and can cause drowsiness. The anticonvulsant effect is realized by preventing the occurrence and propagation of an impulse from the source of activity. The absence form of idiopathic epilepsy will be a contraindication for use.
Frisium , Relanium , Merlit. They belong to the group of benzodiazepines. They are especially often used for progressive myoclonic epilepsy. But over time, the effect may decrease and addiction may develop .
Lamictal , Pamolen. The active ingredient is lamotrigine. It is effective for all types of seizures, but it is recommended to avoid it for myoclonus. The main side effect is a rash, the severity of which increases sharply when combined with valproate and carbamazepine.
Topamax (topiramate). Acts on different mechanisms in preventing attacks, effective in adults and children. Start taking with minimal doses and increase slowly. Use with caution in children with speech disorders, as well as sleep problems. One of the side effects is weight loss, so it should not be used in “thin” patients.
Keppra , Levetinol . The active ingredient is levetiracetam. Optimal action for epileptic myoclonus, does not interact with other drugs. Should not be used in patients prone to agitation and sleep disturbances.
Suxilep. Previously it was the drug of choice for the treatment of absence seizures, but has now given way to valproic acid. Contraindicated for mental problems. Side effects: headache, drowsiness, gastrointestinal symptoms.
Tebantin , Neurontin , Gabapentin . Structurally similar to GABA, they are not transformed in the liver, so they can be used with many other drugs and for liver diseases. Side effects: weakness, dizziness, weight gain.
Since the treatment of epilepsy in many cases involves lifelong use of drugs, the balance between their effectiveness and toxicity is important. Drug metabolism pathways (in the liver) and interactions with other drugs in concomitant diseases also play a role. The selection of anticonvulsant drug therapy is a joint effort between the doctor and the patient.
Surgery
Certain surgical procedures can help relieve neuralgia pain when the condition does not respond to treatment.
Examples of surgical procedures that may help treat neuralgia include:
Microvascular decompression : Helps remove an enlarged blood vessel affecting a nerve. The procedure involves placing a soft pad between the blood vessel and the affected nerve.
Stereotactic surgery : This is a non-invasive procedure that directs highly concentrated beams into the root of the damaged nerve. The radiation disrupts the transmission of pain signals to the brain.
Percutaneous balloon compression : This involves inserting a small balloon into the affected nerve. The balloon is inflated, causing controlled, deliberate nerve damage. This procedure prevents the affected nerve from sending pain signals to the brain. However, the effects of the procedure usually wear off after 1-2 years.
general information
The trigeminal nerve consists of sensory and motor fibers. It originates in the structures of the brain and is divided into three branches:
- ophthalmic: responsible for the eye, forehead and upper eyelid;
- maxillary: innervates the area from the lower eyelid to the upper lip;
- mandibular: involves the chin, lower jaw, lips and gums.
With neuralgia, one or more branches of the trigeminal nerve are affected, which determines the main symptoms of the pathology. People over 45 years of age are most susceptible to the disease, and women get sick more often than men.
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Trigeminal neuralgia is a serious pathology that can seriously disrupt a person’s normal lifestyle. Don't let pain and fear take over your thoughts, get treatment at Health Energy.