Trigeminal neuralgia is a fairly common disease, and, according to statistics, the most often exposed to the fair sex after 40 years. As a rule, neuralgia is of two types: primary (idiopathic, essential, typical) and secondary (symptomatic). In addition to unilateral, neuralgia can be bilateral.
Trigeminal neuralgia. Causes
The main causes of this disease can be complications after the extracted teeth, pulpitis, as well as poorly made dentures. Trigeminal neuralgia in some cases occurs due to pressure on the nerve of the blood vessels, this provokes severe pain and a change in the nerve impulse. Often such a reaction can give vascular tumors, and allergic reactions can become a catalyst for such a disease. In some cases, the branches of the trigeminal nerve are subjected to pressure from the bony canals of the skull through which they pass. The narrowing of these canals is congenital and acquired, for example, in inflammatory processes in the nasopharynx or in the mouth.
Trigeminal neuralgia. Symptoms
The disease is most often expressed by short paroxysms of excruciating intense pain, which are periodic shooting in the area of trigeminal nerve branch innervation. Touching the skin of the trigger zone (eyebrows, nose wings, lip skin, nasolabial folds) cause another attack of shooting pains. Most often, the pain affects one part of the face, the initial symptoms of neuralgia are expressed in itchy skin, the appearance of goose bumps on a certain part of the face. Sometimes involuntary contractions of the facial muscles can be observed, seizures are quite strong and there is no pattern in their appearance. During the day, they can manifest themselves up to ten times.
Trigeminal neuralgia. The most common treatment
Treatment for neuralgia is usually symptomatic and antiepileptic. The most commonly used drug is carbamazepine, which is considered the most effective treatment for neuralgia. The drug is prescribed with an individual dose selection, as a rule, the dose is gradually increased by one tablet per day. To enhance the action of the drug, antihistamines and vitamins are prescribed, and vasodilating and antispasmodic drugs are also indicated. From physiotherapy, diadynamic currents, ion galvanization with amidopyrine or novocaine, phonophoresis with hydrocortisone are used.
For some types of neuralgia, treatment is recommended to start with local and general painkillers. Of the local ones, lidocaine or anesthesin ointment is most often used , which is rubbed into the gum at the site of the pain syndrome. Anesthesia, as a rule, occurs within 3-5 minutes and lasts for half an hour. With the ineffectiveness of therapeutic treatment, surgical intervention is possible, which today is of two types:
- Microsurgical decompression of the trigeminal nerve branch.
- Transection of a branch of the trigeminal nerve.
With treatment, remission occurs within a few days .
Alcoholization of the peripheral branch of the trigeminal nerve leads to rapid remission, however, each subsequent alcoholization reduces the duration of remission and the therapeutic effect of using this method is significantly reduced. As a result of this procedure, destructive changes occur, and, in addition to neuralgia, the patient develops iatrogenic neuritis.
Given the foregoing, it can be understood that none of the methods gives one hundred percent healing from this disease. Some of the remedies provide temporary relief, but basically they are all aimed at eliminating the symptoms of this disease, which means that there is no absolute remedy for the treatment of neuralgia.