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Neuralgia is a neuropathic pain condition affecting one or more nerves. It can be caused by damage to the peripheral or central nervous system. The document discusses several types of neuralgia - trigeminal, glossopharyngeal, postherpetic, and occipital neuralgia. It provides details on symptoms, causes, diagnosis, and management of trigeminal neuralgia, which involves sudden, severe facial pain that may be treated initially with carbamazepine or phenytoin medication or potentially through microvascular decompression surgery.
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NEURALGIA PPT .pdf
- 1. Dr. K. MALATHI PGSCHOLAR Department OF KAYACHIKITSA
- 2. Neuralgia (Greek neuron,"nerve" + algos, "pain") is pain in the distribution of one or more nerves, • Neuropathic pain is pain caused by damage or disease affecting the somato sensory system. • Neuropathic pain may result from disorders of the peripheral nervous system or the central nervous system (brain and spinal cord).
- 3. •Trigeminal neuralgia •Glossopharyngeal neuralgia •Postherpeticneuralgia •Occipital neuralgia
- 4. Glossopharyngeal Neuralgia • Painin tonsillar fossa • Back of the throat, larynx and radiating towards ear • Pain while Swallowing • Not very common
- 5. Postherpetic neuralgia • Occursas a complication of Shingles a viral infection, characterized by painful rash, blisters • May be anywhere on the body • Neuralgia can occur wherever the outbreak of shingles • Pain can be mild/ persistent/ intermittent • Some cases pain may occur before the rash • Occurs along with the path of nerve so its usually isolated to one side of the body
- 6. Occipital Neuralgia • Itis a condition in which the occipital nerves, the nerves that run through the scalp, are injured or inflamed. • Headache that feel like severe piercing, throbbing • shock-like pain in the upper neck, back of the head or behind the ears. • generally starts at the base of the head and goes to the scalp on one or both sides of the head.
- 7. Trigeminal neuralgia • Trigeminalneuralgia (TN or TGN), also called Fothergill disease, tic douloureux, or trifacial neuralgia is a long- term pain disorder that affects the trigeminal nerve • It is a neuropathic pain in the distribution of the one ore more divisions of the Trigeminal neuron. • TN Syndrome: Sudden, severe, paroxysmal of neuropathic pain
- 8. • Unknown • Infections •Vascular compression on nerve root • Exposure to cold, blow, chewing, eating, hot and cold drinks • Diabetes • Less common causes - Chemical irritation Trauma Chroni kidney disease
- 9. Symptoms • S –Site of the pain • O – Onset • C – Character • R – Radiation • A – associate with • T – Time (duration) • E – Exacerbating and relieving • S – Severity of pain
- 10. Socrates…. Sympto m Site Onse t Radiation Characte r Tim e Associate dwith Exacerbate and relieving Seviarit y • SITE – Unilateral facial pain common in mandibular, maxillary and ophthalmic region • ONSET – sudden, paraxismal pain • CHARACTER –cutting, stabbing, electrical shock like • RADIATION – angle of the mouth to ear, eye, nostril • ASSOCIATED WITH – spasticity, winces, flushing of face, lacrimation • TIME - 1 to 2 min duration only • EXACERBATING AND RELIEVING FACTORS – spontaneous, allodynia – movement/smile/eating/chewing/swallowing, soft touch- tactile allodynia • SEVERITY – Very severe, cluster of attacks, jerks
- 11. Aetiology Compression of bloodvessels, esp. superior cerebellar artery Chronic irritation of Trigeminal Nerve at the root Increased firing of the sensory fibres TRIGEMINAL NEURALGIA
- 12. Types of trigeminalneuralgia • CLINICAL TN: NO serious associated symptoms NO sensory loss NO interictal numbness Blood vessel compressing to nerve • SYMPTOMATIC TN : Sensory loss Interictal facial numbness Cranial nerve involvement Myaline and Axon damage
- 13. • History • Trigeminalnerve examionation • diagnostic nerve blocking • EEG • MRI (brain )
- 14. Differential Diagnosis • MultipleSclerosis • Vascular pain – migrane, temporal arteritis • Atypical facial pain- depression, anxiety • Other neuralgias- Postherpetic neuralgia Glassopgaryngeal neuralgia Post traumatic neuralgia • Sudden unilateral neuralgia type of pain with conjunctioval involvement SUNCT
- 15. MANAGEMENT 1ST line –Carbamezapine 2nd line – Phenytoin Baclofen Lamotrigine 3rd line – Clonazepam Valproic acid Oxacarbamezapine Analgesics
- 16. Surgery • Microvascular decompression •Peripheral neurectomy • Cryotherapy • Radiofrequency gangliolysis • Balloon Microcompression(MVD)
- 17. Dr. K. MALATHI PGSCHOLAR DEPT OF KAYACHIKITSA