Contraction of the trigeminal nerve is an extremely unpleasant and painful disease. It is accompanied by intolerable shooting pains in the face. Any movement or touching the affected area can provoke an attack. For this reason, the patient avoids active facial expressions, and sometimes a long conversation. The appearance of the patient worsens, his face looks distorted. What is the reason for this pathology? And how to get rid of a pain syndrome? We will consider these issues in the article.
Pathology Description
12 pairs of nerves depart from the brain. They provide the functioning of various organs and systems. The trigeminal nerve forms the fifth pair. It runs on both sides of the head and is responsible for the sensitivity of the face.
The trigeminal nerve is divided into 3 branches on the left and on the right. Each of them innervates certain areas of the face:
- The first branch. It is responsible for the sensitivity of the forehead, upper eyelids and orbits.
- The second branch. Innervates the cheeks, lower jaw, lips and gums, as well as the upper eyelid.
- The third branch. Provides sensitivity to the masticatory muscles and lower part of the oral cavity.
We can say that the entire facial zone is penetrated by branches of the trigeminal nerve. Therefore, pathological changes in these structures are accompanied by severe pain syndrome.
Under the influence of various adverse factors, pinching of the trigeminal facial nerve occurs. In this case, compression of its fibers occurs. An inflammation appears, which in medicine is called neuritis. In the future, the structures of the nerve are destroyed, which is accompanied by severe unbearable pain. In this case, doctors talk about neuralgia.
Causes
Why does pinching of the trigeminal nerve occur on the face? The following factors can provoke this pathology:
- Infection. A fairly common cause of damage to nerve fibers are viruses. Most often, pathogen of shingles leads to pathological changes - Herpes Zoster. This microorganism in a "sleeping" state is present in the body in people who have had chickenpox in the past. With any decrease in immunity, the virus activates and attacks the peripheral nerves.
- Immune Disorders If the patient has weakened the body's defense against infections, then not only herpes can cause nerve inflammation. Often, neuritis appears after a cold or flu.
- Exposure to cold. Staying in frost leads to hypothermia of the facial part of the skull. The habit of walking without a hat in the winter is a fairly common cause of trigeminal damage. Temperature extremes are especially dangerous when a person goes out of the heat in a cold room.
- Facial injuries. Strong bruises are accompanied by swelling of the tissues. As a result, pinching of the trigeminal nerve occurs. Its fibers can also be squeezed by bone fragments during fractures.
- Tumors Both malignant and benign neoplasms in the skull can compress nerve fibers.
- Caries and its complications. Neglected dental diseases are often the cause of neuritis. Untreated caries can lead to periostitis (flux), which is accompanied by severe swelling of the face. As a result, nerve fibers are compressed by swollen tissues.
- Inflammatory processes. Neuritis can develop as a complication of otitis media or sinusitis. Inflammation passes from the ear cavity and sinuses to the trigeminal nerve.
- Genetic disorders. Some patients have a congenital anomaly in the location of blood vessels on the face. In this case, the arteries and veins press on the nerve.
- Complications after surgery. During maxillofacial surgery, the trigeminal nerve can be damaged.
- Multiple sclerosis. This severe autoimmune pathology often causes facial nerve damage in young patients. It is accompanied by the destruction of the shells of neurons.
- Physical activity and physical inactivity. If a person has to overexert facial muscles, then this can cause a pinched nerve. However, low mobility and a complete lack of physical activity can also trigger neuralgia.
- Stress and malnutrition. Such adverse factors cannot be the direct cause of pinching of the trigeminal nerve on the face. However, overwork, emotional stress and vitamin deficiency adversely affect immunity. And this leads to an exacerbation of infectious and inflammatory diseases. Neuritis occurs as a complication of these pathologies.
Clinical picture
The leading symptom of pinching the trigeminal nerve is severe pain in different parts of the face. Patients describe their sensations as intolerable and painful, similar to electric shocks.
Usually pain occurs in the form of short seizures. They can last about 1 to 2 minutes and repeat several times a day. Soreness usually occurs on one side of the face. This is a typical clinical picture of neuritis.
Less commonly observed is an atypical course of pinching of the trigeminal nerve. Symptoms and treatment of this type of pathology are completely different than with the classical form. In this case, the pain is less pronounced, but it is observed almost constantly. Atypical forms of neuritis are very difficult to treat.
Any effect on the facial area, even very weak, can provoke the appearance of a pain syndrome. Typically, an attack is preceded by the following circumstances:
- washing;
- brushing your teeth;
- touching the face;
- active facial movements;
- chewing;
- a long conversation;
- applying cosmetics;
- wind blow.
Quite often, an attack occurs after a visit to the dentist. In this case, the patient mistakenly accepts manifestations of facial neuritis as toothache. It is important to remember that caries treatment alone cannot cause nerve damage. Dental procedures can only provoke the appearance of pain if the patient already has neuritis.
Pain syndrome is not the only manifestation of pathology. The patient also has other symptoms of pinching of the trigeminal nerve on his face:
- salivation;
- lacrimation
- facial asymmetry;
- depletion of facial expressions;
- trembling of the facial muscles from the side of the lesion;
- slight fever;
- headache;
- reddish skin rashes in the area of the affected nerve;
- feeling of constant fatigue.
This disease adversely affects the mental state of a person. Due to frequent bouts of excruciating pain, the patient becomes irritable, anxious, restless. He fears any touch on the face.
If the neck hurts
Can there be pinching of the trigeminal nerve in the cervical region? Often, patients associate pain in the upper spine with facial neuralgia. However, such symptoms have a completely different origin.
The trigeminal nerve does not pass in the cervical region. It innervates exclusively the facial area. In the upper part of the spine are the roots of the spinal cord. They can also be pinched, which is accompanied by severe pain, which is localized in the head, neck and shoulders.
However, discomfort in the front of the neck can be a symptom of pinching the trigeminal nerve. In the cervical spine of pain radiating from the lower jaw. This is noted when the third branch of the nerve is affected. In this case, the patient sometimes can not determine exactly where it hurts. Differentiate facial neuritis from other pathologies can only a doctor.
Possible complications
Contraction of the trigeminal nerve is an unpleasant and dangerous pathology. In advanced cases, this disease can lead to changes in the structure of the facial muscles. Such a consequence can occur in the absence of treatment within 1 - 1.5 months.
With neuritis, the patient's facial expression changes significantly. As a result, muscle shortening (contracture) occurs. The person's face looks tight and distorted. On the part of contracture, frequent muscle twitches are noted. This leads to a serious cosmetic defect, which requires a long treatment.
Diagnostics
What to do if a person has signs of pinching of the trigeminal nerve? Must visit a neurologist. Usually, the diagnosis of this disease is not difficult, since its manifestations are quite specific. Pathology is detected already during the study of the anamnesis and external examination of the patient.
However, sometimes the symptoms of pinching of the trigeminal nerve are very similar to the manifestations of other diseases, for example, temporal tendonitis or occipital neuralgia. In this case, the doctor may prescribe additional diagnostic procedures:
- MRI or CT;
- electromyography;
- electroneurography.
If there is a suspicion of the viral origin of neuritis, then a test for herpes may also be required.
Drug therapy
How to treat trigeminal pinching? The choice of treatment method depends on the degree of damage and the severity of pain. It is also necessary to consider the primary or secondary nature of neuritis. If inflammation is provoked by other pathologies, then the underlying disease must be cured.
First of all, you need to stop the pain syndrome. For this purpose, patients are prescribed non-steroidal anti-inflammatory drugs:
- Ketanov.
- Nise.
- Diclofenac.
- Ibuprofen
- Dexalgin.
If the above drugs do not help, then you have to use narcotic painkillers:
- "Tramadol".
- "Promedol".
- Nurofen Plus (with codeine).
However, such drugs are not intended for long-term therapy, as they can be addictive and severely addictive.
Anticonvulsant carbamazepine or its structural analogue Finlepsin is often used to treat pinching of the trigeminal nerve. It relaxes muscles and reduces pain. In addition, the drug also has a sedative effect. It helps relieve anxiety and irritability, and also promotes sound sleep.
However, painkillers can only alleviate the manifestations of neuritis. To get rid of attacks, it is necessary to eliminate inflammation and irritation of the nerve. For this purpose, corticosteroid hormones are prescribed:
- Prednisone.
- "Dexamethasone".
- Hydrocortisone.
In mild cases, these drugs are used in tablet form, and in severe cases, they are administered as injections.
If the patient already develops complications of neuritis and there are muscle contractures, then muscle relaxants are indicated:
- Midokalm.
- "Baclofen."
- Sirdalud.
These drugs eliminate muscle spasms.
If the herpetic origin of neuritis is established, then antiviral agents are prescribed:
- "Acyclovir."
- "Famvir".
- "Valacyclovir".
Against the background of frequent bouts of pain, patients often experience mood disorders and anxiety. In such cases, antidepressants are indicated: Amitriptyline, Lerivon, Lyudiomil.
Complex therapy is supplemented with injections of B vitamins. These drugs have neuroprotective properties. They improve the condition of nerve fibers and contribute to a speedy recovery.
Physiotherapy
Physiotherapy is used as an additional method of treating trigeminal pinching on the face. Procedures cannot affect the cause of the pathology, however, they improve the patient's condition and reduce pain.
Quite often, with neuritis, acupuncture is used. The impact of medical needles on certain points of the face helps to restore the sensitivity of the affected areas, relieve inflammation and strengthen local immunity. However, such procedures can be performed only after relief of acute pain. Acupuncture cannot be combined with other types of physiotherapy and taking analgesics.
Patients note that after several sessions, their pain decreased and the frequency of seizures decreased. It can be concluded that acupuncture is an effective method of treating trigeminal pinching. In the photo below you can see how this procedure goes.
With the defeat of the trigeminal nerve, warming physiotherapy is indicated:
- UHF;
- galvanic currents;
- warming up with a quartz lamp;
- applying heated ozokerite or paraffin.
In this case, moderate heat exposure is used. Excessive heating can provoke an increase in the inflammatory process.
With neuritis, face massage sessions are often prescribed. Such procedures help prevent contractures. Massage relieves tension of the general facial muscles and selectively restores the tone of the affected muscles. In addition, the procedures improve blood circulation and relieve inflammation.
Treatment of pinching of the trigeminal nerve with massage cannot be carried out independently. After all, any careless touch to the face can provoke a pain attack. It is better to trust a professional massage therapist. Only a specialist can determine exactly what points of the face can be affected.
After stopping the pain syndrome, exercise therapy is recommended. This helps prevent shortening of facial muscles. Gymnastics for the face is done in front of the mirror. The following types of exercises are shown:
- frowning forehead and eyebrows;
- winking with each eye alternately;
- drawing air into the nasal passages;
- lips and tongue movements;
- rinse your mouth with water or air;
- folding lips into tubes;
- pronouncing whistling sounds.
Such facial exercises must be done twice a day. Sometimes it is very difficult for patients to make active movements of their facial muscles. In such cases, gymnastics should be preceded by a massage session or physiotherapy with galvanic currents.
Surgery
Most often, facial neuritis lends itself to conservative therapy. However, in some patients, the use of drugs and physiotherapy has no effect. In such cases, you have to resort to surgical treatment. The operation is indicated for persistent and severe pain syndrome, which is not stopped by drugs, as well as for frequent attacks.
Nowadays, the following types of operations are used:
- Electrocoagulation Under local anesthesia, an electrode is inserted into the cheek. This leads to a violation of nerve conduction and relief of pain. Such an intervention helps in the early and middle stages of the pathology.
- Decompression. This operation is indicated in cases where the nerve is compressed by the vessels. Decompression is carried out under general anesthesia. They remove the membrane from nerve fibers and thereby eliminate pinching. Then, a special gasket is placed between the trigeminal nerve and the vessel. This is a rather complicated operation, but it is effective even with advanced pathology.
- Plastic surgery of the facial nerve. Pinching can be triggered by rupture of a nerve due to injury. The patient undergoes a microsurgical operation to suture nerve fibers.
- Autotransplantation. If the patient has a strong asymmetry of the face and paralysis of the facial muscles, then this indicates atrophy of the nerve. In such cases, an autotransplantation is necessary. A piece of the femoral nerve is taken from the lower limb of the patient. Atrophied nerve fibers on the face are replaced with this material. Such an operation leads to the restoration of the movements of the facial muscles. After surgery, only a small scar remains near the ear.
Doctors suggest surgery if conservative treatment fails for 7-8 months. In such cases, it is better to agree to surgical intervention, since irreversible changes in the muscles and nerve fibers may develop in the future.
Prevention
How to prevent facial nerve pathology? The following recommendations will help reduce the risk of neuritis:
- It is necessary to avoid hypothermia of the face and scalp. In winter, you should wear a warm hat.
- It is necessary to promptly and completely cure infections of the ENT organs.
- In no case should you start caries. Dental diseases often cause neuritis.
- Soft bruises on the face should be avoided.
- Patients who have had a herpes infection or chicken pox in the past should undergo regular medical examinations. It is important to remember that the virus remains forever in the nerve roots and can be activated at any time.
When a pain syndrome occurs in the facial area, you need to immediately visit a neurologist. In the early stages, neuritis is easily treatable by conservative methods.