Trigeminal neuralgia - causes, symptoms, treatment

Chronic facial inflammation is more common in women of mature age, mainly over 50 years of age. This form of neuralgia is accompanied by very painful and specific symptoms, so it is easy to diagnose. It is important to constantly prevent relapses of the disease and treat them in a timely manner to prevent complications.

Trigeminal neuralgia - causes

The exact origin of the described pathology has not yet been clarified. There are suggestions that the facial nerve is irritated as a result of its compression by blood vessels. According to another version, trigeminal neuralgia occurs against the background of infringement of the trigeminal root by large neoplasms in the area of the Varoliev bridge (part of the brain). Sometimes other negative factors become causes of inflammatory processes.

Atypical trigeminal neuralgia

The stimulator of facial pain in this case is intense psychological or emotional stress. This trigeminal neuralgia is often diagnosed in women who suffer from migraines and are regularly exposed to stress. Signs of pathology systematically intensify, over time they may be constantly present. Atypical neuralgia is provoked by the following circumstances:

dental procedures;
weather change;
thermal effects;
climate change;
lack of sleep.

Postherpetic trigeminal neuralgia

The type of disease in question is associated with previously suffered herpes zoster. The herpes (zoster) that causes it affects the branches of the facial nerve, provoking inflammatory processes. Even after recovery, the virus remains in organic structures for a long time and periodically leads to relapses of the disease. Postherpetic neuralgia often ends with complete recovery after 4-6 weeks. In rare situations, mainly in the absence of correct treatment, the pathology becomes complicated or becomes chronic.

Why is neuralgia dangerous during pregnancy?

Neuralgic damage to nerve fibers is a serious test for a pregnant woman. The pathology requires immediate treatment, as it can provoke the development of the following complications:

pain shock;
spread of the disease to neighboring muscles;
development of dysfunction of the respiratory system and partial atrophy of the abdominal muscles;
inflammation in the area of intervertebral discs;
deviations in the functioning of the musculoskeletal system.

However, there is good news: in the vast majority of mothers, the disease goes away on its own immediately after the baby is born, regardless of the method of delivery. In isolated cases when neuralgia does not go away, the condition requires thorough drug correction.

Now let’s return to the forms of neuralgia that pregnant women encounter most often.

Trigeminal neuralgia - symptoms

The main symptom of this disease is pain. It occurs in attacks that can last from 2 seconds to several days. Trigeminal neuralgia is characterized by excruciating, sharp or “shooting” pain on one side of the face (less often, on both). During a relapse, a person tries not to move and freezes so as not to provoke increased discomfort.

Trigeminal neuralgia - symptoms:

facial muscle spasms (tic);
spread of pain to the neck, ear, jaw and eyes;
change in facial expressions;
irradiation of pain into the hand (often the index finger on the left).

Is it possible to steam if the sciatic nerve is inflamed?

If your sciatic nerve is inflamed (sciatica), then in the first days, as mentioned above, you should not go to the steam room while overcoming the pain. The disease manifests itself as lumbago in the lower back, especially when carrying heavy objects or working at an angle, radiating to the leg and literally preventing one from walking normally. In this case, you should immediately consult a doctor and get recommendations for treatment.

After being treated for the first 3-4 days and relieving the acute condition with medications, you can go to the bathhouse, but you should adhere to the following rules:

Under no circumstances should you douse yourself with cold water, jump into an ice hole, or rub yourself with snow. This will only provoke an exacerbation of pain.
Try to refrain from physical activity in the steam room, including whipping a broom on the place where pain is felt.
Rub salt on the sore spot. Salt draws out water and helps relieve swelling, reducing pain.

The same recommendations should be followed if you have developed neuralgia or worsened osteochondrosis.

Trigeminal neuralgia - diagnosis

Only a qualified and experienced neurologist can differentiate the described pathology and other similar diseases. The doctor carefully examines the patient and collects a detailed history, determines the frequency of pain and all the factors that provoke it. Based on the data obtained, the diagnosis of “neuralgia” is established. To clarify the causes of the inflammatory process, the doctor may prescribe a magnetic resonance imaging of the head.

What physical therapy methods help better than warming up?

Methods of physiotherapeutic treatment of neuralgia are varied; the following are suitable for the treatment of trigeminal:

in the acute period with neuralgia, the use of diadynamic (DDT) or sinusoidally modulated currents (SMT) provides a good analgesic effect. The electric field affects the processes of generation and conduction of impulses in the nerve fiber, that is, it acts on the cause of neuropathic pain;

electrophoresis with solutions of local anesthetics is a more gentle method compared to injection blockades, but also quite effective. The anesthetic drug penetrates directly to the nerve fiber and blocks the impulse;

phonophoresis with hydrocortisone on the area of trigger zones inhibits the generation of spontaneous pain impulses and reduces the frequency of attacks and the intensity of pain.

Conclusion: With idiopathic (primary) neuralgia, warming simply will not help, because the cause is unknown and, as a rule, with primary neuralgia the pain will be “hidden” deep. In the case when the cause is known, symptomatic neuralgia will certainly not be treated by heating, here you need to get rid of the cause: treat the consequences of herpes, get rid of a tumor, look at the maxillary sinus, etc. If there are no contraindications to warming up and such procedures help to reduce the pain at least a little, then you can use a heating pad, or a bag of salt or cherry pits.

If no means of treating trigeminal neuralgia, neither physiotherapy, nor medications, etc., help. Then it may be worth considering surgical treatment.

How to treat trigeminal neuralgia?

It is extremely rare to completely eliminate the disease in question. The reason for this is the difficulty of identifying the factors that provoke inflammation. The main goal of therapy is to relieve or completely relieve the symptoms of the pathology (pain and spasms). Trigeminal neuralgia treatment involves complex:

taking medications;
acupuncture;
manual influences;
natural remedies;
surgical intervention (if other methods are ineffective).

Trigeminal neuralgia: treatment - drugs

The basis of the traditional medical approach is the use of anticonvulsants in parallel with muscle relaxants and antispasmodics. The most effective medicines:

Finlepsin;
Carbamazepine;
Lamotrigine;
Oxcarbazepine;
Baclofen;
Gabapentin;
Phenytoin;
Clonazepam;
sodium valproate preparations;
Tegretol.

The listed drugs are recommended for long-term use with a gradual reduction in dosage to the level of a maintenance dose. Standard anti-inflammatory painkillers for trigeminal neuralgia are not used due to their low effectiveness. Anesthetics cannot adequately relieve discomfort and relieve spasms of the facial muscles.

If conservative approaches do not work and trigeminal neuralgia continues to progress, intraosseous blocks or injections into the Gasserian ganglion are used. At the same time, physiotherapeutic manipulations are carried out. If the expected effect is not achieved, the specialist will recommend a minimally invasive surgical method to combat the problem.

Acupuncture for trigeminal neuralgia

Acupuncture is considered a popular procedure for pain relief, but qualified doctors are skeptical about it. According to numerous studies, trigeminal neuralgia can be relieved only with the help of conservative medicine - acupuncture treatment is one of a number of alternative methods without scientific justification. According to test results, acupuncture only helps those patients who believe in its effectiveness (placebo effect). There is no reliable evidence of pain relief by inserting needles into the skin.

Massage for trigeminal neuralgia

Any manual procedures are prescribed only by a doctor as part of complex conservative therapy. Massage is especially often recommended if trigeminal neuralgia has worsened during pregnancy, when using standard treatment options is dangerous for the fetus. The manipulation is carried out by an experienced specialist in a course of 15-22 sessions. Manual influence involves only stroking, rubbing and light vibration. Other massage techniques are prohibited.

Trigeminal neuralgia – surgery

The most effective and safe method of surgical treatment of the described inflammatory process is radiofrequency destruction (rhizotomy). Trigeminal neuralgia of the face is accompanied by severe pain due to the receipt of electrical impulses in the brain. If you stop transmitting such signals, all unpleasant sensations will disappear.

During the minimally invasive surgery, a very thin needle is inserted through the skin of the cheek under local anesthesia and X-ray guidance. When it reaches the root of the affected nerve, a powerful high-frequency electromagnetic pulse is applied to the tip of the device. It leads to a sharp increase in temperature in the damaged structure and its subsequent destruction.

Neuralgia of the trigeminal pinched nerve can also be eliminated by other surgical methods:

Shoquist operation;
microvascular decompression;
Spiller-Freser operation (retrogasseral nerve root transection);
exeresis of peripheral branches;
balloon transcutaneous decompression;
operation Dandy;
vascular decompression;
cryodestruction;
radiosurgery (gamma knife);
classic decompression.

The listed options for medical interventions are associated with a high risk of serious side effects and postoperative complications, so they are used extremely rarely and only if there are direct indications (tumors, pathological location of blood vessels). In some situations, exposure to the affected roots can lead to irreversible changes in facial expressions and even disability.

Treatment

Your main task is to promptly seek help from specialists and prevent the progression of neuralgia. A painful reaction, and quite intense, will cause the release of adrenaline, which can cause increased uterine tone in early pregnancy or even premature birth. Therefore, if pain occurs, you must immediately consult with a leading gynecologist, who will refer you to a neurologist for treatment.

The advice of traditional medicine and the use of spontaneously selected analgesics deserve special attention. Most of these drugs are strictly contraindicated during pregnancy.

Treatment of neuralgia during pregnancy is difficult, because... Most drugs prescribed for the treatment of neuralgia are contraindicated. Antiepileptic drugs have proven themselves well in treatment. But such drugs increase folic acid deficiency, which is already common during pregnancy. A deficiency of this acid will cause birth defects in newborns. But such a negative effect occurs only when taking the drug in the first trimester of pregnancy; otherwise, the drugs have no effect on the development of the fetus. Therefore, such treatment is prescribed only with strict control of the substance in the blood plasma, and if the benefit outweighs the risk.

But still more often, in the early stages of pregnancy, treatment is limited to vitamin therapy. The dose of B vitamins is selected individually. Transcutaneous electrical stimulation and acupuncture are prescribed as additional treatment methods.

In the absence of positive dynamics from conservative treatment, other, more aggressive treatment methods may be prescribed:

alcohol blockades - the introduction of alcohol into the branch area of the affected nerve branch. The results of the procedures are relatively short-term, and the pain will return again, but they are prescribed if it is necessary to prolong the time;
surgical treatment, when the doctor tries to surgically eliminate compression of the nerve trunk. If this is not possible, then the trigeminal nerve itself is destroyed;
Gamma and Cyber Knife are the latest treatment methods that allow surgical treatment without incisions and blood.

Intercostal neuralgia

Between the 12 pairs of ribs there are a large number of nerve endings. If the peripheral nerves are pinched in the thoracic region, severe pain occurs under the scapula. If the clamping occurs on the left side, the symptoms of a neurological disease are often confused with pain in the heart. The causes of inflammation of nerve endings can be:

osteochondrosis and compressor fracture;
hypothermia and hormonal imbalance;
lung disease and anemia;
multiple sclerosis and diabetes mellitus;
scoliosis and kyphosis.

What symptoms indicate inflammation if a person has a cold on the nerve under the scapula?

pain in the thoracic spine, radiating to the neck or lower back;
impaired sensitivity of the skin at the site of inflammation;
burning and itching in the area of the shoulder blade;
increased pain when sneezing, coughing and moving.

Review of effective drugs

Let's talk about how to treat a cold trigeminal nerve. In pharmacotherapy, an integrated approach using symptomatic and pathogenetic drugs is used to eliminate neuritis. The most effective in eliminating neuralgia will be:

"Acyclovir" is an antiviral agent that helps eliminate pathogens at the site of inflammation;
“Promedol” is an anesthetic drug that affects the functioning of the central nervous system, preventing the processing of impulses coming from affected tissues;
"Indomethacin" is a non-steroidal anti-inflammatory drug that promotes decompression of the affected nerve bundles;
"Dexamethasone" is a glucocorticosteroid hormone that eliminates inflammation and swelling of tissues;
"Mydocalm" is a muscle relaxant that inhibits the reflex excitability of nerve cells.

Inflammation of the trigeminal nerve can occur due to hypothermia or general infection of the body.

To eliminate neuritis, drugs with antiviral, analgesic and antiphlogistic effects are used. They help decompress the facial nerve and restore its protective sheath.

The skin and muscles of the face are intersected by a complex system of nerves and nerve endings. The trigeminal nerve is one of the most important nodes responsible for the sensitivity of almost all parts of the head and face. If the trigeminal nerve is cold, treatment must be immediate and serious. After all, the consequences of this disease can be anything, including serious inflammatory processes and complete loss of sensitivity of the face and eyes.

Causes of inflammation

Why does the trigeminal nerve become inflamed? There are several reasons for this. Most often, the disease begins after a cold. Herpes, blows to the face, or prolonged exposure to cold may also be the cause. Pain may occur due to compression of the nerve roots by incorrectly placed fillings or dentures. Inflammation can also begin due to infectious diseases of the mouth, nose or throat. It often occurs due to vascular pathologies or circulatory disorders. If you have been diagnosed with trigeminal nerve inflammation, treatment should begin by eliminating the cause.