The neuralgia is characterized by repeated bouts of pain located in the territory of distribution of one or more nerves.
The most common is the trigeminal neuralgia. Its incidence is 8 to 13 per 100,000 inhabitants / year and increases with age, affecting more women than men.
Not infrequently trigeminal neuralgia and other headaches with migraine or migraine or tension headaches, which are completely different confused.
The patient reported crisis intense stabbing pain or similar to a usually unilateral and located in the distribution of one or more nerve branches electric shock, a few seconds to two minutes long ,.
In the case of the trigeminal neuralgia ( the trigeminal has three branches ), usually represents the second or third branches, affecting the area of the nasal ala and upper jaw or jaw, although sometimes can manifest into several branches.
The pain may occur spontaneously or triggered by tactile stimuli, cold, heat, chewing, etc., on certain areas called“& rdquo trigger zones;.
Typically the patient tries not talking or chewing, touching your face or brushing your teeth to avoid pain.
Types of neuralgia
According to their cause can be essential, idiopathic (cause unknown) or secondary (due to tumors, aneurysms, arteriovenous malformations, trauma, alcohol, diabetes, infections, inflammatory causes etc. )
Considering the affected nerve, the most common are the cranial neuralgia: the trigeminal, glossopharyngeal, or occipital neuralgia, among other. The post-herpetic neuralgia caused by herpes zoster, also very common, can affect any nerve trunk of the body and usually occurs after having a herpes zoster.
The forms called essential have no apparent cause nerve injury producing. The neuralgia secondary are due to the existence of a lesion that invades or compresses the nerve, such as a tumor, vascular malformations, demyelinating diseases ( eg. multiple sclerosis ), infectious ( as produced by the herpes zoster virus ) or others.
In the case of the trigeminal neuralgia, it has been observed that in many patients who have undergone surgery for a supposedly neuralgia actually existed blood vessels that were compressing the trigeminal root.
The explanation of how the pain would be the hyperexcitability of nerve fibers and the transmission of stimuli from the fibers are vehicles touch other leading pain occurs due to a loss of substance that surrounds fibers (myelin ) that promotes contact of axons ( the prolongation of neurons that conduct nerve impulses ).
In the case of the neuralgia secondary, the treatment of choice is the originating cause ( resection of tumors, aneurysms, treat infections, etc. )
If there is a primary neuralgia, essential or idiopathic, the treatment of choice is the pharmacological.The most used and effective antiepileptic drugs are.
Sometimes there are instances of neuralgia do not respond to drugs, in which case would be indicated Surgical Treatment, in which you try to free the possible nerve vascular compression or damage the fibers that carry the pain.
Most employees in the trigeminal neuralgia are the thermocoagulation, balloon compression, microvascular decompression of the trigeminal root, gamma -knife radiosurgery, trigeminal root section, or so-called peripheral neurolysis <. / p>
Sometimes you have to use both types of treatment: Medical and Surgical