Trigeminal neuralgia: Causes, Diagnostic and Treatment
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Trigeminal neuralgia (facial nerve) — a painful, severe pain in the projection of the branches of the trigeminal nerve caused him annoyance. Damage typically occurs with one hand. The pain in this type of neuralgia is one of the most powerful, localized in the jaw and lower face, supraorbital region and the area around the nose. By the force of the pain reminds electric shocks. This type of pathology is complex to treat, apply complex medical and surgical therapies.
Trigeminal neuralgia: Anatomy of a nerve
Trigeminal nerve refers to the fifth pair of cranial nerves that ensure sensitivity and movement in the face and mouth. Area ophthalmic and maxillary branch carries sensory function, mandibular branch — mixed, there is sensory and motor fibers of the chewing muscles. It trigeminal nerve provides the superficial and deep sensitivity of a person, allowing to feel pain, touch and pressure.
- Trigeminal neuralgia: Causes, Diagnostic and Treatment
Trigeminal neuralgia: Causes
Causes of pain in the projection of the Trigeminal neuralgia are numerous. Usually, the pain associated with stimulation of his trunk, or one of the branches as a result of close contact between the arteries and veins to the nerve at the base of the skull, where they go outside. Pain may also be due to compression of the nerve branches tumor, development of multiple sclerosis, which leads to the destruction of nerve membranes. There are central and peripheral factors. To include central pain paroxysms by type of hypothalamic, epileptic, dysphoria. Sharp pain lasting a few seconds and stops spontaneously. This neuralgia is seen as a variant of epilepsy.
By circumferential include:
- neuralgia idiopathic, of unknown origin,
- Primary neuralgia as a result of infection, herpetic lesions and toxic, allergic and cardiovascular effects, irritation or compression of the nerve trunk aneurysm, vascular malformation.
- secondary neuralgia, is the occurrence of pain associated with dental pain, upper respiratory tract, cervical spine, as a result of multiple sclerosis, trauma, tumors.
Trigeminal neuralgia: Manifestations
The main symptoms of trigeminal neuralgia — pain is short-term nature, but it is always very strong, local and unilateral, in the zone of passage of the affected nerve branch. Patients describe the pain like attacks, beginning with shock, reaching a peak for 10-20 seconds and lasts for some time. Then they subside. Seizures can be from once a day for up to several hours.
Attacks of pain accompanied by autonomic symptoms — watery eyes, uncontrollable outflow of saliva, redness of the face. Painful symptoms can be triggered by touching specific points of the face, shaving, make-up, brushing teeth or chewing food, talking. If there is a loss of the mandibular branch of the trigeminal nerve, there are signs of movement disorders — atrophy, cramps or muscle twitching face. Symptoms of secondary neuralgia depends on the level of the lesion, and the specific reasons for the defeat of the forces.
Current neuralgia can be lengthy. Periods of remission alternating with relapses, and the duration of periods of bright individual.
Trigeminal neuralgia: Diagnostics
Usually the diagnosis is made clinically, based on the patient’s complaints and external neurological examination. Instrumental diagnosis is MRI in identifying tumors, sclerosis lesions vascular changes. In secondary neuralgia necessary consultation dentist, ENT and other professionals.
Trigeminal neuralgia: Therapies
One of the most difficult questions in neuroscience is the problem of how to treat trigeminal neuralgia. Treatment is divided into conservative and operative. Reduce or stop the pain helps receiving anticonvulsants with individual selection of doses, and the drug baclofen used. Treatment of symptomatic neuralgia include resolving, anti-inflammatory and physical therapy. With the ineffectiveness of conservative measures of operative treatment. Today there are many methods of surgical correction of trigeminal neuralgia. Each operation has its indications and contraindications, different efficiencies. Surgical treatment is used to block the receipt of pulses or eliminate compression of the nerve branches. Begin with simple blockages nerve branches novocaine or alcohol, radiofrequency coagulation. With the ineffectiveness of used root transection or the intersection of the descending nerve nucleus.
Trigeminal neuralgia: Forecast
Without treatment neuralgia typically does not pass on their own, exhausting the patient and sometimes leads to suicide because of the pain. Methods of conservative therapy are effective in the secondary lesions. Idiopathic form need surgical treatment, which mostly leads to the disappearance of pain and improve quality of life.