Neuralgia: Types, Causes, Diagnosis and Treatment

It is a throbbing, burning, and often severe pain due to an irritated or damaged nerve.

The nerve can be anywhere in the body and the damage can be caused by several things, including:

  • Aging.
  • Diseases such as diabetes or multiple sclerosis.
  • An infection, such as herpes zoster.
  • The treatment for the pain of neuralgia depends on the cause.

Types of neuralgia

Neuralgia Posherpética

This type of neuralgia occurs as a complication of shingles and can be anywhere in the body. Shingles is a viral infection that is characterized by a rash and painful blisters.

Neuralgia can occur wherever shingles has occurred. The pain can be mild or severe and persistent or intermittent.

It can also last for months or years. In some cases, the pain may occur before the rash. It will always occur along the path of a nerve, so it is usually isolated on one side of the body.

Neuralgia Trigeminal

Trigeminal Neuralgia is a condition that affects the fifth cranial nerve, the Trigeminal Nerve, and causes chronic pain. The Trigeminal nerve has three branches that extend into its face.

The trigeminal nerve supplies nerves to almost the entire face.

Branches of the Trigeminal Nerve

The upper part of the trigeminal nerve is called the ophthalmic branch, the middle branch is the maxilla and the lower branch is the mandible.

These nerves are responsible for the sensation you feel when you wash your face, shave, brush your teeth or put on makeup. But if you have Trigeminal Neuralgia, these simple activities can trigger a pain attack.

Neuralgia glosofaríngea

Neuralgia is a severe pain caused by an injury or damage to a nerve. The glossopharyngeal nerve is the ninth cranial nerve that arises from the brainstem within the skull.

Provides sensation to the back of the throat, tongue and parts of the ear

When the glossopharyngeal nerve becomes irritated, an intense pain like an electric shock is felt in the back of the throat, tongue, amygdala or ear.

Initially you may experience short and mild attacks, with periods of remission. But neuralgia can progress, causing longer and more frequent blistering pain attacks.

Causes of neuralgia

The cause of some types of nerve pain is not fully understood. You may feel nervous pain from damage or injury to a nerve, pressure on a nerve, or changes in the way nerves work.

The cause may also be unknown.

Infection

An infection can affect your nerves. For example, the cause of postherpetic neuralgia is herpes zoster, an infection caused by the varicella virus.

The probability of having this infection increases with age. An infection in a specific part of the body can also affect a nearby nerve. For example, if you have an infection in a tooth, it can affect the nerve and cause pain.

Multiple sclerosis

Multiple sclerosis (MS) is a disease caused by the deterioration of myelin, the covering of the nerves. Trigeminal neuralgia can occur in someone with MS.

Pressure on the nerves

Pressure or compression of the nerves can cause neuralgia. The pressure can come from a:

  • Bone.
  • Ligament.
  • Blood vessel.
  • Tumor.
  • The pressure of a swollen blood vessel is a common cause of trigeminal neuralgia.
  • Diabetes

Many people with diabetes have problems with their nerves, including neuralgia. Excess glucose in the bloodstream can damage nerves. This damage is more common in the hands, arms, feet and legs.

Less common causes

If the cause of the neuralgia is not infection, multiple sclerosis, diabetes or pressure on the nerves, it can be due to one of many less common factors. These include:

  • Chronic kidney disease.
  • Medications prescribed for cancer.
  • Fluoroquinolone antibiotics, used to treat some infections.
  • Trauma, as by surgery.
  • Chemical irritation

When to seek medical help?

The pain of neuralgia is usually severe and sometimes debilitating. If you have it, you should see your doctor as soon as possible.

You should also see your doctor if you suspect that you have herpes zoster. In addition to neuralgia, shingles also cause a red, bullous rash.

It is usually found on the back or abdomen, but it can also be on the neck and face. Shingles should be treated as soon as possible to avoid complications.

These may include Postherpetic Neuralgia, which can cause debilitating and lifelong pain.

Diagnosis

What to expect at a medical appointment?

When you see your doctor for neuralgia, you may be asked a series of questions about your symptoms. Your doctor will want you to describe the pain and tell you how long it has been a problem. You should also inform them about any medication you take and any other medical problems you have.

This is because neuralgia can be a symptom of another disorder, such as diabetes, multiple sclerosis, or shingles.

Your doctor will also perform a physical exam to identify the location of the pain and the nerve that is causing it, if possible.

You may also need a dental exam. For example, if the pain is on your face, your doctor may want to rule out other possible dental causes, such as an abscess.

To find an underlying cause of your pain, your doctor may order certain tests. Blood may need to be drawn to control blood sugar levels and kidney function.

A Magnetic Resonance Imaging (MRI) test can help your doctor determine if you have multiple sclerosis. A nerve conduction velocity test can determine nerve damage.

It shows how fast the signals move through your nerves.

Treatment of neuralgia

If your doctor can identify the cause of your neuralgia, your treatment will focus on treating the underlying cause. If the cause is not found.

The potential treatment may include:

  • Surgery to relieve pressure on the nerve.
  • Better control of blood sugar levels in people with neuralgia caused by diabetes.
  • Physical therapy
  • Nervous blockage, which is an injection targeted at a nerve or nerve in particular group and which is intended to “turn off” pain signals and reduce inflammation.
  • Medications to relieve pain Prescription medicines may include:
  • Antidepressants such as Amitriptyline or Nortriptyline, which are effective in treating nerve pain.
  • Anticonvulsant medications such as Carbamazepine, which is effective for trigeminal neuralgia.
  • Narcotic drugs for short-term pain, such as codeine.
  • Topical creams with Capsaicin.