Trigeminal neuralgia is a relatively common disease, which is accompanied by inflammation, pinching, squeezing and other lesions of the nerve endings. Pathology is characterized by the appearance of very unpleasant symptoms, including sharp bouts of pain. Treatment of trigeminal neuralgia is possible, but in this case it is extremely important to diagnose the disease on time.
Of course, patients are interested in additional information about the disease. Why does trigeminal neuralgia develop? Clinic, diagnosis, treatment, symptoms and possible complications are, of course, important information that is worth exploring.
Information on the structure and functions of the trigeminal nerve
Trigeminal nerves are the fifth pair of cranial nerves. The nerve begins in the tissues of the warolium bridge and is mixed: it contains both sensitive and motor roots.
The nerve is divided into three branches, which, in fact, is evidenced by its name:
- the orbital branch provides sensitivity to the skin of the eye, upper eyelid and forehead;
- the maxillary branch innervates the tissues of the lower eyelid, nostrils, cheeks, upper lip and gums of the upper jaw;
- the mandibular nerve is responsible for the sensitivity of the lower lip, lower jaw and gums, and also ensures the activity of some masticatory muscles.
Damage to any branch of the nerve is accompanied by severe pain, and sometimes a violation of the sensitivity of the skin, muscles and other structures.
It is worth noting that humanity has been facing a similar problem since ancient times. The first information about the appearance in people of characteristic pains in the face area refers to the period of the Roman Empire. Of course, due to a lack of knowledge, treatment of trigeminal neuralgia was reduced to taking opium. Therapy helped to successfully cope with the pain, but was addictive and did not help eliminate the cause of the development of the disease.
Why is there a problem?
Many people are interested in information about the symptoms and treatment of trigeminal neuralgia. As already mentioned, this pathology is associated with damage to nerve roots of various origins.
- In most cases, attacks of neuralgia are associated with compression of the nerve or its peripheral ganglion, located in the cranial cavity. In the place where the nerve leaves the brain stem, the superior cerebellar artery is located. If the vessel has pathological tortuosity or an aneurysm (expansion and thinning of the walls of the artery) formed in this place, then nerve fibers are compressed.
- Normally, the axons of the trigeminal nerve are covered with a myelin sheath, which provides fast transmission of the nerve signal. Damage to such a membrane is fraught with the appearance of symptoms of neuralgia. Such a pathology can develop against the background of acute disseminated encephalomyelitis, multiple sclerosis, opticomyelitis Devik.
- A tumor that has arisen from the tissues of the nerve or meninges begins to put pressure on certain parts of the trigeminal nerve as it grows, which leads to the development of neuralgia. Neoplasms can be either benign or malignant. A classic example of this condition is neurofibromatosis.
- Risk factors include injuries. Injuries, strokes, bruises of the brain can lead to hemorrhages and the formation of cysts that compress and damage certain branches of the trigeminal nerve.
- Neuralgia can be caused by an infection, in particular herpes. With a similar disease, blistering rashes appear on the skin, which are located along the trigeminal nerve. If sharp pain occurs against the background of infection, this indicates that the herpes virus has penetrated into the nerve tissue.
The causes, symptoms and treatment of trigeminal neuralgia are closely related. That is why during the diagnosis it is important to determine what triggered the development of pathology.
Main symptoms
Clinic, treatment of trigeminal neuralgia - this is important information that many are interested in. Symptoms of the disease are very characteristic. Patients note pain that covers the right or left side of the face (depending on which side the nerve is affected from). Discomfort extends to the orbits of the eyes, lips, teeth, less commonly the cheeks, wings of the nose and the skin of the forehead.
Attacks occur instantly. The pain is sharp, burning, similar to the discharge of an electric current. It does not extend to the neck, shoulder and other parts of the body, but is localized only in the face. By the way, often people take this symptom for a toothache.
Attacks can last about a few seconds, less often 1-2 minutes. At first they rarely appear, but as the disease progresses, the diseases become more frequent. The pain is so sharp and intense that a person sometimes freezes, becomes speechless. An attack can even end in a swoon.
In addition, lacrimation, increased salivation, and involuntary contraction of the facial muscles are possible. Some patients report an increase in sensitivity, and sometimes, on the contrary, numbness of the skin of the lips, nose, and eyelids. Sometimes you can see the appearance of redness on the skin.
What can provoke an attack of pain?
Attacks of pain sometimes occur on their own, but, as a rule, their appearance is associated with irritation of certain nerve endings. Even the most simple, daily actions can provoke a pain syndrome:
- water and food intake;
- teeth cleaning;
- shaving (when it comes to men);
- applying cosmetics to the skin (for example, make-up or regular care cream);
- pain may appear during laughter, crying, normal conversation;
- there are so-called "trigeminal" odors, the inhalation of which can trigger an attack (ammonia, acetone are included in their list).
What complications does the pathology lead to?
Treatment of trigeminal neuralgia in most cases ends successfully. But the disease should not be underestimated - the lack of therapy is fraught with a variety of complications.
- In the area of the lesion, nutrition of the skin tissue is possible. The integument here is significantly thinning. Some patients report loss of eyelashes and eyebrows.
- The lack of treatment for trigeminal neuralgia can result in persistent facial paresis.
- Significant hearing impairment is also included in the list of complications.
- If there is a violation of blood flow, then the formation of a hematoma in the tissues of the cerebellum is possible, which can affect the work of the whole organism.
- Constant bouts of pain cannot but affect the patient’s emotional state. Patients become lethargic, irritable. They are always in a bad mood and as the disease develops, they begin to avoid communication. Often, a nerve lesion ends in a depressive state.
Diagnostic measures
Diagnosis and treatment of trigeminal neuralgia is important information that many people are interested in.
The presence of certain symptoms in the patient may already prompt the doctor to think about nerve damage. Patients undergo tests and undergo some examinations. It is worth noting that today the most effective and informative are magnetic resonance and / or computed tomography. To examine the nerve branches you will need high-resolution equipment. Such a procedure, by the way, makes it possible to determine the cause of the onset of the disease (the presence of tumors, hematomas, dilated blood vessels, etc.).
Only after receiving all the necessary information, the doctor can draw up a truly effective treatment regimen for trigeminal neuralgia. In no case should you ignore the problem or try to cope with the disease yourself.
Trigeminal neuralgia: drug treatment
After the diagnosis, the doctor will be able to draw up an effective treatment regimen. Symptoms and treatment of trigeminal neuralgia are closely related.
- Anticonvulsants are used to relieve arousal from neurons, thereby eliminating pain. As a rule, small doses of “carbamazepine” are prescribed to patients for this purpose.
- Muscle relaxants are also considered effective. Such drugs act on neurons that are responsible for supporting muscle tone, thereby relieving spasm, tension, and alleviating pain. The most commonly used drugs are Midokalm, Baclofen, and Sirdalud.
- Sometimes the treatment regimen includes the use of analgesics, anti-inflammatory drugs and antispasmodics. Such drugs relieve pain only with a mild form of pathology.
- Treatment of postherpetic trigeminal neuralgia includes the use of antiviral drugs. Also, patients take medications that stop neuropathic pain: Tebantin, Neurontin.
- Vitamin therapy is also extremely important. Patients must be prescribed B vitamins. During an exacerbation of an ailment, these drugs in combination with ascorbic acid are administered by injection.
- Sometimes some physiotherapeutic procedures are also included in the treatment regimen. Effective is considered the impact of dynamic currents, phonophoresis using hydrocortisone, galvanization with novocaine.
Nerve blockade with drugs
If treatment of trigeminal neuralgia with drugs does not give the desired effect, the doctor may decide to conduct more radical procedures. In particular, blockade of the affected nerve gives a good effect.
- Sometimes a blockade of individual branches of the nerve is performed. For this purpose, novocaine or alcohol is introduced into the tissues. A similar procedure is shown if only one branch of the trigeminal nerve is affected. The effect of the introduction of painkillers is temporary and lasts no more than a year.
- If there is a defeat of two branches or the entire nerve, then the blockade is carried out at the level of the Gasser node. To administer the drug, a less traumatic puncture is performed, which allows the doctor to access the temporal bone. As a rule, sterile glycerol is introduced into the ganglion. This substance gradually kills the nerve, thereby relieving pain.
Surgery
Surgical treatment of trigeminal neuralgia is carried out if conservative methods of therapy do not give the desired effect - the patient continues to suffer from pain. The choice of procedure depends on the condition of the sick person.
- In some cases, the doctor using special laser equipment destroys the accumulation of neurons in the affected nerve.
- If neuralgia is the result of compression of the nerve fiber of the vessels, then decompression is performed (Janet's operation). During the operation, the doctor carefully separates the vessel, and the freed nerve is “covered” with a special synthetic tube or muscle flap.
- In some cases, dissection of the beams is required, which provide the transmission of an impulse to the sensitive nucleus of the trigeminal nerve (it is located in the medulla oblongata).
- To date, the safest procedure is the destruction of certain sections of a nerve or ganglion using a gamma knife.
- At one time, doctors cut the trigeminal nerve root to relieve pain. For this, a full trepanation was performed, since the doctor needed to get direct access to the cranial cavity. Today, such operations are not carried out almost anywhere, as they involve a host of unpleasant complications.
Of course, such therapy gives results. Nevertheless, during some operations, a large-scale nerve damage is possible - the patient loses sensitivity in half of the face. Since a person no longer feels skin and muscles, he can easily bite his lip or cheek, injure himself. That is why patients undergoing a similar procedure, it is recommended to carefully monitor the condition of the tissues on the face and in the oral cavity, regularly undergo dental examinations.
Despite such serious consequences, many patients agree to the operation, because, as already mentioned, the pain caused by nerve damage can be unbearable.
Treatment of trigeminal neuralgia with folk remedies: effective recipes
Of course, traditional medicine offers a lot of recipes that are effective in certain forms of neuralgia. It is worthwhile to understand that these drugs only help relieve symptoms and alleviate the patient’s condition - they cannot be used to eliminate the cause of the trigeminal lesion.
- Fir oil is considered an effective remedy. Oil applied to a cotton swab gently treats the skin on the affected side of the face. The procedure is recommended to be repeated at least six times a day. According to reviews, at first the skin is redder and even slightly swelling, but after 2-3 days the pain becomes less intense.
- In some cases, warming is beneficial. For this purpose, use ordinary buckwheat. First, grits should be thoroughly heated in a pan (without oil, stirring constantly). Hot grains are placed in a bag of cotton cloth - and it must be applied to the affected part of the face. The procedure is repeated three times a day.
- You can make alcohol tincture. We pour 50 g of dried plantain flowers into a glass jar and pour a glass of vodka. The container must then be closed. The medicine should be infused in a cool, dark place for seven days. The resulting tincture gently rub the affected part of the face, then wrap it with a warm down scarf. The procedure is best done before bedtime. The full course consists of 5-10 repeated procedures. During this time, patients usually begin to feel better.
- Special tea will help relieve inflammation. To prepare it, you need to take three parts of dry St. John's wort grass and two parts of lavender flowers. A tablespoon of a mixture of medicinal plants, pour 500 ml of boiling water. Cover the container with a lid and let it brew for 20 minutes. The resulting infusion should be filtered and drunk in a glass twice a day instead of tea (if desired, you can slightly sweeten).
- Leaflets of red geranium can be applied to the affected cheek - on top they need to be fixed with plastic wrap and insulated with a woolen scarf.
- Some folk healers recommend periodically making steam baths for the face using a hot decoction of young aspen bark. This procedure must be carried out very carefully and only with the permission of the attending physician.
- Delicious tea will help to cope with pain, irritation and tension. To prepare it, you will need green mint branches. They are poured with a glass of boiling water, after which the mixture is boiled for 10 minutes. The resulting broth needs to be filtered, divided into two parts and drunk during the day.
It should be understood that treatment of trigeminal neuralgia with folk remedies is possible only with the permission of a doctor. Self-medication attempts can only exacerbate the situation.
Massage for inflammation
Treatment of trigeminal neuralgia at home includes a massage that the patient can do on his own. You need to massage the neck from the affected side in the direction from the shoulder to the chin. Movements must be very careful.
For the procedure, use a special oil that can be prepared at home. To do this, you need to take 100 g of bay leaves (it is better to take fresh raw materials, but in case of which dried), grind them, put them in a glass jar and pour 0.5 l of vegetable oil (you can take, for example, olive). The container is closed with a lid and insisted for a week.
Oil is used not only for massage. Some herbalists recommend simply lubricating the skin along the affected nerve with this remedy several times a day. By the way, if the pain syndrome is not too intense (mild neuralgia), then the face can be massaged, and from the center to the periphery.
Homemade compresses
There are other ways to relieve the symptoms of trigeminal neuralgia. Treatment with folk remedies includes the use of special compresses.
- Effective are the leaves of cabbage. First you need to boil them slightly and cool slightly. A warm sheet is applied to the diseased half of the face, covering with a terry towel from above. Once the compress has cooled, it must be replaced with the next hot sheet.
- To combat pain, cosmetic clay or healing mud can be used (they are sold in pharmacies and cosmetic stores). Dry powder must be diluted with warm water so that a thick, mushy mixture is obtained - it must also be applied to the skin on the affected side of the face. . 1-2 .
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These simple procedures will help cope with nerve pinching and relieve bouts of pain. Moreover, regular gymnastics for the face helps to improve blood circulation, strengthen muscles, slow down the formation of wrinkles. Of course, the doctor selects the methods of treatment for trigeminal neuralgia. Therefore, before starting the "gymnastics" course, be sure to consult a specialist, since in some cases excessive tension on the face muscles and stimulation of nerve endings can only aggravate the situation.
Preventive actions
Many people are successfully treated for trigeminal neuralgia. Reviews of specialists, as well as statistical studies, confirm that the disease is well amenable to therapy. Nevertheless, this is a long process, which is sometimes associated with certain complications. Obviously, it is much easier to prevent the development of pathological changes.
Unfortunately, specific prophylactic agents do not exist. Doctors, however, recommend that you follow some rules:
- it is important to eat right, include fresh vegetables and fruits in the daily diet, as this helps to strengthen the immune system;
- you also need to go in for sports, maintain physical fitness, temper, because it also increases the body's resistance to infections;
- it is important to avoid stress (sharp fluctuations in the hormonal background affect the functioning of the immune system);
- all infectious and inflammatory diseases, including sinusitis, caries, sinusitis, need to be treated on time;
- It is also worth avoiding drafts, injuries, hypothermia, dressing in the weather;
- giving up bad habits, including smoking and drinking strong drinks, will also have a positive effect on the body.
If you still notice some kind of abnormality, then you should undergo a physical examination and be sure to inform your doctor about all the symptoms.