neuralgia

enUK

neuralgia

(no͝orăl`jə, nyo͝o–), acute paroxysmal pain along a peripheral sensory nerve. Unlike neuritisneuritis
, inflammation of a peripheral nerve, often accompanied by degenerative changes in nervous tissue. The cause can be mechanical (injury, pressure), vascular (occlusion of a vessel or hemorrhage into nerve tissue), infectious (invasion by microorganisms), toxic (metallic
..... Click the link for more information. , there is no inflammation or degeneration of nerve tissue. Neuralgia occurs commonly in the area of the facial, or trigeminal, nerve and brings attacks of excruciating pain at varying intervals. Often no cause can be found for trigeminal neuralgia, and in severe cases deadening of the nerve with novocaine or alcohol, or even surgical interruption of the nerve, is necessary to bring relief. Neuralgia can be caused by such disturbances as diabetes, infections, diseases of the nervous system, anemia, and extreme cold. The pain may occur for many months after an attack of shingles (see herpes zosterherpes zoster,
infection of a ganglion (nerve center) with severe pain and a blisterlike eruption in the area of the nerve distribution, a condition called shingles. The causative organism is varicella-zoster, a common, filtrable virus that also causes chickenpox, and can hide
..... Click the link for more information. ), and it is one of the symptoms of syphilitic involvement of the central nervous system. In many cases, pain can be relieved by hot applications, drugs, and various kinds of physiotherapy.

Neuralgia

a pathological condition that is characterized by attacks of pain at the innervation site of a peripheral nerve. In contrast to neuritis, neuralgia does not involve motor disturbances or a loss of sensitivity, and structural changes in the affected nerve are not observed.

Neuralgias develop predominantly in nerves that pass through narrow canals and openings. With primary, or essential, neuralgia no accompanying diseases are clinically observed; with secondary, or symptomatic, neuralgia inflammatory processes, tumors, or other conditions harmful to nerves can arise. Should the neuralgia be prolonged, a neuritic stage can arise in which structural changes accompanied by a loss of sensitivity in the nerve become apparent.

Neuralgia produces paroxysmal pains and such autonomic vascular disturbances as reddening of the skin and lacrimation; sometimes localized muscle spasms in the form of painful tics occur. Neuralgia most commonly affects the trigeminal nerve; other nerves, such as the greater and lesser occipitals and the glossopharyngeal, are less frequently involved.

Secondary neuralgias are treated by curing the causative disease. In primary neuralgia, treatment involves injections of Novocain, topical use of Xylocaine, physiotherapy, and the use of B vitamins. Antispasmodics are specifically used for neuralgia of the trigeminal nerve.

V. A. KARLOV

neuralgia

[nu̇′ral·jē·ə] (medicine) Pain in or along the course of one or more nerves. Also known as neurodynia.

neuralgia

severe spasmodic pain caused by damage to or malfunctioning of a nerve and often following the course of the nerve

neuralgia

enUK

Neuralgia

Definition

Neuralgia is defined as an intense burning or stabbing pain caused by irritation of or damage to a nerve. The pain is usually brief but may be severe. It often feels as if it is shooting along the course of the affected nerve.

Description

Different types of neuralgia occur depending on the reason the nerve has been irritated. Neuralgia can be triggered by a variety of causes, including tooth decay, eye strain, or shingles (an infection caused by the herpes zoster virus). Pain is usually felt in the part of the body that is supplied by the irritated nerve.

Causes and symptoms

Neuralgia is caused by irritation or nerve damage from systemic disease, inflammation, infection, and compression or physical irritation of a nerve. The location of the pain depends on the underlying condition that is irritating the nerve or the location of the particular nerve that is being irritated.Neuralgia can result from tooth decay, poor diet, eye strain, nose infections, or exposure to damp and cold. Postherpetic neuralgia is an intense debilitating pain felt at the site of a previous attack of shingles. Trigeminal neuralgia (also called tic douloureux, the most common type of neuralgia), causes a brief, searing pain along the trigeminal nerve, which supplies sensation to the face. The facial pain of migraine neuralgia lasts between 30 minutes and an hour and occurs at the same time on successive days. The cause is not known.Glossopharyngeal neuralgia is an intense pain felt at the back of the tongue, in the throat, and in the ear—all areas served by the glossopharyngeal nerve. The pain may occur spontaneously, or it can be triggered by talking, eating, or swallowing (especially cold foods such as ice cream). Its cause is not known.Occipital neuralgia is caused by a pinched occipital nerve. There are two occipital nerves, each located at the back of the neck, each supplying feeling to the skin over half of the back of the head. These nerves can be pinched due to factors ranging from arthritis to injury, but the result is the same: numbness, pain, or tingling over half the base of the skull.

Diagnosis

Neuralgia is a symptom of an underlying disorder; its diagnosis depends on finding the cause of the condition creating the pain.To diagnose occipital neuralgia, a doctor can inject a small amount of anesthetic into the region of the occipital nerve. If the pain temporarily disappears, and there are no other physical reasons for the pain, the doctor may recommend surgery to deal with the pinched nerve.

Treatment

Glossopharyngeal, trigeminal, and postherpetic neuralgias sometimes respond to anticonvulsant drugs, such as carbamazepine or phenytoin, or to painkillers, such as acetaminophen. Trigeminal neuralgia may also be relieved by surgery in which the nerve is cut or decompressed. In some cases, compression neuralgia (including occipital neuralgia) can be relieved by surgery.People with shingles should see a doctor within three days of developing the rash, since aggressive treatment of the blisters that appear with the rash can ease the severity of the infection and minimize the risk of developing postherpetic neuralgia. However, it is not clear whether the treatment can prevent postherpetic neuralgia.If postherpetic neuralgia develops, a variety of treatments can be tried, since their effectiveness varies from person-to-person.

antidepressants such as amitriptyline (Elavil)
anticonvulsants (phenytoin, valproate, or carbamazepine)
capsaicin (Xostrix), the only medication approved by the FDA for treatment of postherpetic neuralgia
topical painkillers
desensitization
TENS (transcutaneous electrical nerve stimulation)
dorsal root zone (DREZ) surgery (a treatment of last resort)

Alternative treatment

B-complex vitamins, primarily given by intramuscular injection, can be an effective treatment. A whole foods diet with adequate protein, carbohydrates, and fats that also includes yeast, liver, wheat germ, and foods that are high in B vitamins may be helpful. Acupuncture is a very effective treatment, especially for postherpetic neuralgia. Homeopathic treatment can also be very effective when the correct remedy is used. Some botanical medicines may also be useful. For example, black cohosh (Cimicifuga racemosa) appears to have anti-inflammatory properties based on recent research.

Prognosis

The effectiveness of the treatment depends on the cause of the neuralgia, but many cases respond to pain relief.Trigeminal neuralgia tends to come and go, but successive attacks may be disabling. Although neuralgia is not fatal, the patient's fear of being in pain can seriously interfere with daily life.Some people with postherpetic neuralgia respond completely to treatment. Most people, however, experience some pain after treatment, and a few receive no relief at all. Some people live with this type of neuralgia for the rest of their lives, but for most, the condition gradually fades away within five years.

Key terms

Desensitization — A technique of pain reduction in which the painful area is stimulated with whatever is causing the pain.Dorsal root entry zone (DREZ) — A type of nerve surgery for postherpetic neuralgia that is occasionally used when the patient can get no other pain relief. The surgery destroys the area where damaged nerves join the central nervous system, thereby interfering with inappropriate pain messages from nerves to the brain.Glossopharyngeal neuralgia — Sharp recurrent pain deep in the throat that extends to the area around the tonsils and possibly the ear. It is triggered by swallowing or chewing.Migraine neuralgia — A variant of migraine pain, also called cluster headache, in which severe attacks of pain affect the eye and forehead on one side of the face.Occipital neuralgia — Pain on one side of the back of the head caused by entrapment or pinching of an occipital nerve.Postherpetic neuralgia — Persistent pain that occurs as a complication of a herpes zoster infection. Although the pain can be treated, the response is variable.Shingles — A painful rash with blisters that appears along the course of a nerve. It is caused by infection with herpes zoster virus.TENS — The abbreviation for transcutaneous electrical nerve stimulation, a technique used to control chronic pain. Electrodes placed over the painful area deliver a mild electrical impulse to nearby nerve pathways, thereby easing pain.Trigeminal neuralgia — Brief episodes of severe shooting pain on one side of the face caused by inflammation of the root of the trigeminal nerve. Also referred to as tic douloureux.

Resources

Periodicals

Fields, H. "Treatment of Trigeminal Neuralgia." The New England Journal of Medicine 334 (April 1996): 1125-1126.

Organizations

American Chronic Pain Association. P.O. Box 850, Rocklin, CA 95677-0850. (916) 632-0922. 〈http://members.tripod.com/∼widdy/ACPA.html〉.National Chronic Pain Outreach Association. P.O. Box 274, Millboro, VA 24460. (540) 997-5004.Trigeminal Neuralgia/Tic Douloureux Association. P.O. Box 340, Barnegat Light, NJ 08006. (609) 361-1014.

neuralgia

[noo͡-ral´jah] pain in a nerve or along the course of one or more nerves, usually consisting of a sharp, spasmlike pain that may recur at intervals. It is caused by inflammation of or injury to a nerve or group of nerves. Inflammation of a nerve, or neuritis, may affect different parts of the body, depending upon the location of the nerve. Two common types of neuralgia are that of the trigeminal nerve (see tic douloureux) and that of the sciatic nerve (see sciatica). adj., adj neural´gic.neuralgia facia´lis ve´ra Ramsay Hunt syndrome.Fothergill's neuralgia tic douloureux (trigeminal neuralgia).geniculate neuralgia Ramsay Hunt syndrome.glossopharyngeal neuralgia that affecting the petrosal and jugular ganglion of the glossopharyngeal nerve, marked by severe paroxysmal pain originating on the side of the throat and extending to the ear.Hunt's neuralgia Ramsay Hunt syndrome.idiopathic neuralgia neuralgia of unknown etiology, not accompanied by any structural change.intercostal neuralgia neuralgia of the intercostal nerves, causing pain in the side.mammary neuralgia neuralgic pain in the breast.Morton's neuralgia tenderness or pain in the metatarsal area of the foot and in the third and fourth toes caused by pressure on a neuroma of the branch of the medial plantar nerve supplying these toes. The neuroma is produced by chronic compression of the nerve between the metatarsal heads. Called also Morton's foot or toe.

The pain of Morton's neuralgia is frequently made worse with prolonged standing or walking. From Waldman, 2002. nasociliary neuralgia pain in the eyes, brow, and root of the nose.postherpetic neuralgia persistent burning pain and tingling along the distribution of a cutaneous nerve following an attack of herpes zoster.trifacial neuralgia (trigeminal neuralgia) tic douloureux.

neu·ral·gi·a

(nū-ral'jē-ă), Pain of a severe, throbbing, or stabbing character in the course or distribution of a nerve. Synonym(s): neurodynia [neur- + G. algos, pain]

neuralgia

(no͝o-răl′jə, nyo͝o-)n. Sharp, severe paroxysmal pain extending along a nerve or group of nerves.

neu·ral′gic adj.

neuralgia

Nerve pain Neurology Pain along a nerve, more common in the elderly Etiology Injury, irritation, infection–herpes, or idiopathic Clinical Burning pain, worsened by movement or contact with affected areas; trigeminal neuralgia and postherpetic neuralgia are most common. See Glossopharyngeal neuralgia, Neuropathy.

neu·ral·gi·a

(nūr-al'jē-ă) Pain of a severe, throbbing, or stabbing character in the course or distribution of a nerve.
Synonym(s): neurodynia. [neur- +G. algos, pain]

neuralgia

Pain experienced in an area supplied by a sensory nerve as a result of nerve disorder that results in the production of pain impulses in the nerve. Neuralgia may be caused by injury to the nerve, nerve inflammation (neuritis) from any cause, such as virus infection, or by nerve abnormality of unknown origin. Neuralgia is often episodic and may be triggered by a minor stimulus such as a light touch to the area supplied by the nerve. See also TRIGEMINAL NEURALGIA and POSTHERPETIC PAIN.

neu·ral·gi·a

(nūr-al'jē-ă) Variable pain along the course or distribution of a nerve. [neur- + G. algos, pain]

neuralgia

neu·ral·gia

neuralgia

neu•ral•gia

neuralgia

neuralgia

neuralgia

neuralgia

Neuralgia

neuralgia

neuralgia

neuralgia

Neuralgia

Definition

Description

Causes and symptoms

Diagnosis

Treatment

Alternative treatment

Prognosis

Key terms

Resources

Periodicals

Organizations

neuralgia

neu·ral·gi·a

neuralgia

neuralgia

neu·ral·gi·a

neuralgia

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neuralgia

Synonyms for neuralgia

noun acute spasmodic pain along the course of one or more nerves

Synonyms

Related Words