Trigeminal neuralgia is characterized by paroxysmal attacks of facial pain, like a cramp or whiplash, brief seconds, but repetitive, affecting one or more branches of the trigeminal nerve, usually at the bottom of the face. He never cross to the other side and generally respect the language. It may be triggered by different stimuli (eating, talking, shaving …) or a simple touch on areas «trigger» (a peri level or intraoral). There are multiple treatments and reveldes cases resort to surgery.
Possibly the most common cause of neuropathic pain is a herniated disc. The hernia occurs when compressing a root radiculopathy (commonly known as sciatica), with severe pain in the region bearing the sensitivity of that root.
Some patients have pain and tingling in the lower limbs when roam or make efforts. The most common cause of this «claudication» is usually vascular, narrowed arteries that do not provide enough blood, but sometimes are due to a neurological problem and known as neurogenic claudication. Lumbar canal stenosis is one of the causes of such claudication.
Sometimes the chicken pox virus can manifest itself in adults sprouting in the region of a root constituting what is known as zoster or «shingles». This painful condition can persist over time. Neuropathic pain it produces is highly incapacitating. Treatments in the initial phase with antivirals and treatment of neuropathic pain are fundamental to improving the patient.
A complex picture is fibromyalgia, patients with marked muscle pain that may be associated other symptoms such as dizziness, headache, memory impairment. Recent studies relate it with a fine fobra neuropathy. Treatment should be individualized.
FACIAL PAIN
A proper diagnosis of facial pain syndromes involves neuroanatomical knowledge that allows us to define syndromes. In these cases the detailed neurological examination is essential in the differential diagnosis and to exclude serious diseases.
Hypoesthesia or painful, persistent, in the territory of distribution of the trigeminal nerve or one of its branches or the occipital nerves anesthesia. The anesthesia dolorosa is often related to surgical trauma of nerves or trigeminal ganglion, often caused after rhizotomy or thermocoagulation therapeutic classical trigeminal neuralgia.
Persistent facial pain can be initiated by surgery or facial trauma, teeth or gums but persists without any demonstrable local cause. Facial pain around the pinna or temple may precede the detection of ipsilateral lung cancer.
The atypical toothache term has been applied to a continuous pain in the teeth, or in the bed left by a tooth after extraction, in the absence of an identifiable cause tooth
We can also talk about rinalgias and oftalmodinias if the pain is located in the root nasal or eye.
Rinalgia idiopathic syndrome is a stereotypical nasal root pain not due to external compression (goggles, ..) The oftalmodinia is a picture of perorbitario pain not due to other causes
Syndrome burning or burning mouth suede limited to the language (glossodynia). It may be associated with dry mouth, paresthesia and taste disorders. They should initially rule out metabolic and deficiency causes.
Syndrome red ear is a well known entity. He related migraine is an entity that can sometimes present a long-term and generate discomfort with touch. The anesthetic block is a therapeutic option
